Predictors and Outcomes of Vitrectomy and Silicone Oil Injection in Advanced Diabetic Retinopathy
| Autor: | Masoud Soheilian, Mohammad H. Dehghan, Hamid Ahmadieh, Homayoun Nikkhah, Alireza Ramezani, Mehdi Yaseri, Amin Rozegar, Morteza Entezari, Siamak Moradian |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Visual acuity genetic structures medicine.medical_treatment Visual Acuity Vitrectomy Silicone oils Endotamponade Lower risk Injections Young Adult 03 medical and health sciences chemistry.chemical_compound Postoperative Complications 0302 clinical medicine Ophthalmology Humans Medicine Outcome Aged Retrospective Studies Diabetic Retinopathy business.industry Incidence (epidemiology) Retinal Retrospective cohort study General Medicine Odds ratio Diabetic retinopathy Middle Aged medicine.disease eye diseases Treatment Outcome chemistry 030221 ophthalmology & optometry Original Article Female sense organs medicine.symptom business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Korean Journal of Ophthalmology : KJO |
| ISSN: | 2092-9382 1011-8942 |
| DOI: | 10.3341/kjo.2016.0018 |
| Popis: | Purpose To evaluate visual and anatomical results and identify factors that influence vitrectomy and silicone oil (SO) injection outcomes in proliferative diabetic retinopathy (PDR). Methods This retrospective study included 236 eyes with PDR that were undergoing vitrectomy and SO injection with >3-month follow-up. The primary outcomes were final best-corrected visual acuity (BCVA) and retinal attachment rate. Results At the final visit (mean, 88 ± 58 weeks), complete, partial, and no retinal attachment were observed in 86.9%, 10.6%, and 2.5% of patients, respectively. A total of 155 eyes had experienced SO removal, while 81 had SO in place. The mean initial BCVA was 1.9 ± 0.7 logarithm of the minimum angle of resolution (logMAR) and significantly improved to 1.7 ± 0.8 logMAR (p = 0.001). Initial macular detachment (adjusted odds ratio [AOR], 0.25), development of iatrogenic break (AOR, 0.25), and use of heavy SO (AOR, 0.13) were independently associated with a lower risk of final retinal attachment, and SO removal was associated with a higher incidence (AOR, 7.55). Better baseline BCVA was associated with a higher risk of final BCVA ≥20 / 200. Conclusions Despite an encouraging outcome based on anatomical data in advanced PDR treated with vitrectomy and SO, the functional prognosis was not satisfying for patients. Eyes with better vision at baseline had a more favorable prognosis, whereas eyes with initial macular detachment, intraoperative iatrogenic break, or heavy SO showed more unfavorable outcomes. In selected cases, extending the time of SO use did not worsen the prognosis. |
| Databáze: | OpenAIRE |
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