Prospective assessment of proliferative diabetic retinopathy with observations of posterior vitreous detachment
Prospective assessment of proliferative diabetic retinopathy with observations of posterior vitreous detachment
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DOI：
10.1007/s10792-005-5389-2
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发表时间：
2005-02-01
影响因子：
1.6
通讯作者：
Kawakami, Masanobu
中科院分区：
文献类型：
--
作者：
Ono, Ryuichiro;Kakehashi, Akihiro;Kawakami, Masanobu
目的：研究玻璃体后脱离（posterior玻璃体detachment， PVD）与糖尿病视网膜病变（diabetic retinopathy， DR）进展的关系，我们观察到在完全性PVD患者中增殖性DR是罕见的。方法：回顾403例糖尿病患者3年来的病历资料，探讨进展性DR与PVD、HbA（1c）状态的关系。PVD分为无PVD、完全PVD合并塌陷、完全PVD不塌陷、部分PVD合并玻璃体后皮质增厚和部分PVD不合并玻璃体后皮质增厚。DR分为无、单纯、增生前和增生。当它变得更广泛或激光治疗或玻璃体手术时，DR被认为是进行性的。结果：无PVD的128/ 292眼（43.8%）、完全PVD伴塌陷的0/14眼（0%）、完全PVD伴塌陷的2/8眼（25%）、部分PVD伴玻璃体后皮质增厚的15/15眼（100%）和部分PVD伴玻璃体后皮质增厚的19/74眼（25.7%）发生DR进展超过3年。伴有玻璃体后皮层增厚的部分PVD患者比伴有塌陷的完全PVD患者更容易发生DR进展（p < 0.05）。0001)。HbA(1c)，两组间无显著差异(分别为6.9 +/- 0.9%和7.5 +/- 0.9%;p = 0。14)，尽管进展性DR患者的HbA（1c）显著高于非进展性DR患者（7.5 +/- 1.5%）（p = 0.04）（78 +/- 1.8%）。结论：完全PVD是dr的一个重要的负性危险因素，糖尿病患者的PVD状况应进行评估。
Purpose: To study the relation between posterior vitreous detachment (PVD) and progression of diabetic retinopathy (DR), based on our observation that proliferative DR is rare in patients with complete PVD. Methods: The medical records of 403 patients with diabetes were reviewed for the relation between progressive DR and the status of PVD and HbA(1c) over 3 years. PVD was classified into none, complete PVD with collapse, complete PVD without collapse, partial PVD with a thickened posterior vitreous cortex, and partial PVD without a thickened posterior vitreous cortex. DR was classified into none, simple, pre-proliferative, or proliferative. When it became more extensive or when laser treatment or vitreous surgery was performed, the DR was considered progressive. Results: Progression of DR over 3 years occurred in 128/ 292 (43.8%) eyes with no PVD, 0/14 (0%) eyes with complete PVD with collapse, 2/8 (25%) eyes with complete PVD without collapse, 15/15 (100%) eyes with partial PVD with a thickened posterior vitreous cortex, and 19/74 (25.7%) eyes with partial PVD without a thickened posterior vitreous cortex. Progression of DR occurred significantly more frequently in eyes with partial PVD with a thickened posterior vitreous cortex compared to eyes with complete PVD with collapse (p < 0. 0001). HbA(1c), did not differ significantly between these two groups (6.9 +/- 0.9 % and 7.5 +/- 0.9 %, respectively; p = 0. 14), although HbA(1c) was significantly higher (p = 0.04) in patients with progressive DR (78 +/- 1.8%) than in patients without progressive DR (7.5 +/- 1.5%). Conclusion: Complete PVD is a strong negative risk factor for DR. The PVD status in patients with diabetes should be evaluated.