| Objective: To investigate the comparison of the treatment effect of two types of PDR(proliferative diabetic retinopathy)PPV(pars plana vitrectomy)and associated risk factors.Methods:One single-center retrospective study.The patients diagnosed PPV and got PPV(and/or cataract surgery)were collected in He Eye Specialists Hosp itals since January 2019 to December 2019.According to the inclusion and ex clusion criteria,a total of 197 eyes of 197 patients were included in this study.All eyes were divided into two Group A and Group B.Vitreous hemorrhage w as the major sign in Group A: massive hemorrhage noted in the vitreous under pupil dilated fundus examination and/or on SLO image without obvious prolife rative membrane,no vitreous tractional lesion or traction retinal detachment note d on ultrasound B scan;Fibroproliferative membrane was the major sign in Gro up B: obvious fibroproliferative membrane on the optic disc or posterior pole ar ea along the vascular arch was seen on mydriatic fundus examination and/or SL O image,vitreous tractional lesion or tractional retinal detachment noted on ult rasound B scan,vitreous hemorrhage was allowed.Ninety-four eyes were includ ed in Group A,and 103 eyes were included in Group B.Two experienced retin al doctors evaluated the data separately,the third retinal doctor would make the decision if there was divergence.The main treatment outcome was best correct ed visual acuity(BCVA)at 3 months postoperatively after PPV,Log MAR was used for statistical analysis.The risk factors included in the study were gender,age,baseline BCVA,anti-vascular endothelial growth factor(VEGF)therapy co mbined(no/preoperative/intraoperative),fasting blood glucose,PDR type,duration of diabetes,Hb A1 C,creatinine value,preoperative retinal laser treatment,posto perative vitreous cavity state(perfusion fluid/inert gas/silicone oil),cataract surge ry combined.SPSS26.0(Statistical Product Service Solutions)software was used for statistical analysis,and the multiple linear regression method was used to a nalyze the correlation between the above factors and the best corrected visual a cuity 3 months after surgery.Result:A total of 197 eyes were included in this study,and 94 eyes of 94 patients were in group A,the rest103 eyes of 103 patients were in group B,the average age of group A was 53.48 ± 10.96 years,and average age of group B was 49.27 ± 11.23 years;(1)BCVA:Intra-group comparison: Baseline Log MAR BCVA of group A was 1.57 ± 0.61(Snellen visual acuity: 0.03),and Log MAR BCVA of 3 months after operation was0.54 ± 0.54(Snellen visual acuity: 0.29).There was a statistical difference between the two groups(P=0.01);Baseline Log MAR BCVA of group B was 1.71 ± 0.56(Snellen visual acuity: 0.02)and Log MAR BCVA of 3 months after the operation was0.99 ± 0.63((Snellen visual acuity: 0.10);there was a statistical difference between the two groups(P=0.008).Comparison between groups: There was no statistical difference in baseline visual acuity between the two groups(P=0.098).The visual acuity of group A was significantly better than that of group B at 3 months after operation(P<0.001);The visual acuity difference in group A before and after treatment was-1.04±0.70,and the visual acuity difference in group B before and after treatment was-0.72±0.73.The visual acuity of group A was improved higher than that of group B,which was a statistical difference(P=0.002).(2)Risk factors: The results of multiple linear regression analysis found that the fiber proliferation-based PDR(β=0.203,P=0.004),poor baseline BCVA(β=0.197,P=0.002),silicone oil filling of the vitreous cavity(β=0.290,P<0.001),combined cataract surgery(β=0.129,P=0.044)predicts poor vision at 3 months after surgery.Conclusion: The short-term visual acuity after PPV in the PDR characterized by fibroproliferative membrane is lower than the PDR characterized by vitreous hemorrhage.At the same time,poor baseline BCVA,PDR characterized by fibroproliferative membrane,vitreous cavity silicone oil filling,and combined cataract surgery indicate poor short-term visual recovery after surgery. |
