Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan 2;17(1):310.
doi: 10.3390/ijerph17010310.

Survival Time of Visual Gains after Diabetic Vitrectomy and Its Relationship with Ischemic Heart Disease

Abdah Khairiah Che Md Noor  1 , Evelyn Li Min Tai  2 , Yee Cheng Kueh  1 , Ab Hamid Siti-Azrin  1 , Zamri Noordin  3 , Ismail Shatriah  2
Affiliations

Survival Time of Visual Gains after Diabetic Vitrectomy and Its Relationship with Ischemic Heart Disease

Abdah Khairiah Che Md Noor et al. Int J Environ Res Public Health. .

Abstract

Vitrectomy surgery in proliferative diabetic retinopathy improves the vision-related quality of life. However, there is lack of data on the duration of maintenance of visual gains post vitrectomy. This study thus aimed to determine the survival time of visual gains and the prognostic factors of vision loss after vitrectomy surgery for complications of proliferative diabetic retinopathy. A retrospective cohort study was conducted in an ophthalmology clinic in Malaysia. We included 134 patients with type 2 diabetes mellitus on follow-up after vitrectomy for proliferative diabetic retinopathy. Visual acuity was measured using the log of minimum angle of resolution (LogMar). A gain of ≥0.3 LogMar sustained on two subsequent visits was considered evidence of visual improvement post vitrectomy. Subjects were considered to have vision loss when their post-operative visual acuity subsequently dropped by ≥0.3 LogMar. Kaplan-Meier analysis was used to determine the survival time of visual gains. Cox Proportional Hazard regression was used to determine the prognostic factors of vision loss. The median age of patients was 56.00 years (IQR ± 10.00). The median duration of diabetes mellitus was 14.00 years (IQR ± 10.00). Approximately 50% of patients with initial improvement post vitrectomy subsequently experienced vision loss. The survival time, i.e., the median time from surgery until the number of patients with vision loss formed half of the original cohort, was 14.63 months (95% CI: 9.95, 19.32). Ischemic heart disease was a significant prognostic factor of vision loss. Patients with underlying ischemic heart disease (adjusted HR: 1.97, 95% CI: 1.18, 3.33) had a higher risk of vision loss post vitrectomy, after adjusting for other factors. Approximately half the patients with initial visual gains post vitrectomy maintained their vision for at least one year. Ischemic heart disease was a poor prognostic factor for preservation of visual gains post vitrectomy.

Keywords: LogMar; ischemic heart disease; post vitrectomy; prognostic factors; type 2 diabetes mellitus.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier curve for vision loss estimates among subjects with visual improvement post vitrectomy for complications of PDR (n = 134).
See this image and copyright information in PMC

References

    1. Letchuman G.R., Wan Nazaimoon W.M., Wan Mohamad W.B., Chandran L.R., Tee G.H., Jamaiyah H., Isa M.R., Zanariah H., Fatanah I., Ahmad Faudzi Y. Prevalence of diabetes in the Malaysian national health morbidity survey III 2006. Med. J. Malays. 2010;65:180–186. - PubMed
    1. Yau J.W., Rogers S.L., Kawasaki R., Lamoureux E.L., Kowalski J.W., Bek T., Chen S.J., Dekker J.M., Fletcher A., Grauslund J., et al. Global Prevalence and Major Risk Factors of Diabetic Retinopathy. Diabetes Care. 2012;35:556–564. doi: 10.2337/dc11-1909. - DOI - PMC - PubMed
    1. Institute for Public Health (IPH) National Health and Morbidity Survey 2015 (NHMS 2015), Non-Communicable Diseases, Risk Factors Other Health Problems. Volume II. Ministry of Health Malaysia; Kuala Lumpur, Malaysia: 2015.
    1. Abougalambou S.S.I., Abougalambou A.S. Risk factors associated with diabetic retinopathy among type 2 diabetes patients at teaching hospital in Malaysia. Diabetes Metab. Syndr. 2015;9:98–103. doi: 10.1016/j.dsx.2014.04.019. - DOI - PubMed
    1. Willis J.R., Doan Q.V., Gleeson M., Haskova Z., Ramulu P., Morse L., Cantrell R.A. Vision-related Functional Burden of Diabetic Retinopathy Across Severity Levels in the United States. J. Am. Med. Assoc. Ophthalmol. 2017;135:926–932. doi: 10.1001/jamaophthalmol.2017.2553. - DOI - PMC - PubMed

Publication types