Vitreous hemorrhage in diabetic eyes previously treated with panretinal photocoagulation

Vitreous hemorrhage (VH) is a major cause of severe vision loss in diabetic patients. The aim of this study was to assess the incidence and risk factors for new VH in diabetics previously treated with panretinal photocoagulation (PRP) for proliferative retinopathy (PDR) in community base center.

Records of 192 diabetics (35 type 1, 157 type 2), undergoing PRP for diabetic retinopathy were retrospectively reviewed. Eyes presenting initially with high-risk PDR received PRP without delay, and eyes presenting initially with severe non proliferative retinopathy (NPDR) or early PDR had undergone central retinal photocoagulation (CRP), and then, when high risk PDR developed, received PRP treatment.

VH had developed in 39% of the eyes despite PRP. Risk factors for VH in type 1 diabetes were: early onset and long duration of disease (23.8 versus 39.0 years of age, P=0.007, and 25.8 versus 16.0 years, P=0.002, respectively). In type 2, VH occurred with less follow-up and angiographic examinations (7.4% versus 3.8%, P=0.027, and 33% versus 47%, P=0.07, respectively). CRP decreased the risk for VH from 43 to 15%, P=0.013.

In type 2 diabetes, regular ophthalmic follow-up and intensive PRP may reduce the risk for VH in eyes previously treated by PRP. In type 1, early onset disease and long duration are associated with higher incidence of VH.