Risk factors for poor outcomes in eyes with diabetic retinal detachment identified

Age and iris neovascularization were the strongest predictors of poor visual outcomes in eyes that underwent vitrectomy for diabetic retinal traction detachment, according to a retrospective study.

Ellen C. LaHeij and colleagues at the University Hospital in Maastricht, Netherlands, analyzed 44 eyes of 33 patients with diabetes who also had central retinal traction detachment. All patients underwent vitrectomy.

Median visual acuity significantly improved from 20/800 to 20/160 after a median follow-up of 10 months. Half the patients achieved a visual acuity of 20/200 or better. The retina was finally reattached in 38 eyes (86.3%).

Univariate analysis showed that patients with type 2 diabetes, those who were older than 50, a preoperative VA worse than 20/200, iris neovascularization and macular detachment duration of more than 30 days had significantly worse final visual outcomes.

Multiple regression analysis showed that age and the presence of iris neovascularization were the strongest predictors of a poor outcome, the authors said. If both were present, the chance of obtaining a visual result worse than 20/200 was almost 90%.

The study authors noted that while reports in the past 2 decades have described high anatomical success rates in eyes with severe diabetic traction detachment, visual outcomes are only slightly improved.

The study is published in the March issue of Graefe’s Archive for Clinical and Experimental Ophthalmology.