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Published on: January 25, 2019
Referrals for proliferative diabetic retinopathy from two UK diabetic retinopathy screening services: a 10-year
Salman Naveed Sadiq1, Chan Ning Lee2, Ben Charmer1
1Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, SR2 9HP, UK.
Insights
Long-term outcomes for proliferative diabetic retinopathy (PDR) patients in the UK showed severe vision loss was uncommon, but moderate vision loss affected nearly 20%. Vitrectomy was needed for 24% of eyes, emphasizing its importance in PDR management.
Area of Science:
- Ophthalmology
- Diabetology
- Public Health
Background:
- Diabetic eye screening programmes (DESP) identify patients with proliferative diabetic retinopathy (PDR).
- Understanding long-term outcomes for PDR patients referred to tertiary care is crucial for effective management.
Purpose of the Study:
- To evaluate the long-term outcomes of patients with PDR referred from UK DESPs.
- To assess rates of severe vision loss (SVL), moderate vision loss (MVL), and vitrectomy requirements over 10 years.
Main Methods:
- Retrospective multicentre study involving patients referred over a 36-month period (2007-2009).
- Follow-up duration of 10 years.
- Analysis included SVL, MVL, vitrectomy rates, and patient survival using Cox proportional hazards regression.
Main Results:
- Of 109 eyes with active PDR, 7.3% developed SVL and 14.7% developed MVL.
- Vitrectomy was performed in 24% of eyes, primarily for vitreous hemorrhage.
- 10-year survival for PDR patients was 76%; only age significantly impacted survival.
Conclusions:
- While severe vision loss is infrequent, moderate vision loss is a significant concern in PDR patients over 10 years.
- Vitrectomy remains a critical intervention for a substantial proportion of PDR eyes.
- Age is a key factor influencing long-term survival in PDR patients.
Background/Objectives:
To determine long-term outcomes of patients referred with proliferative diabetic retinopathy (PDR) from diabetic eye screening programmes (DESP) to tertiary care centres in the United Kingdom (UK).
Methods:
Retrospective multicentre study of patients referred from two DESPs in the UK over a 36-month period (2007-9) and followed-up for 10 years. Critical outcomes included severe vision loss (SVL) and the need for vitrectomy. Other outcomes assessed included moderate vision loss (MVL), and patient survival time. Univariate and multiple variable Cox proportional hazards regressions were used to analyse survival outcomes.
Results:
212 eyes of 150 patients were referred with a diagnosis of PDR. 109 eyes of 72 patients were confirmed to have active PDR and included in the study. 61% of patients had low-risk PDR, while 39% exhibited high-risk features in at least one eye. Eight (7.3%) eyes developed SVL and 16 (14.7%) MVL during follow up. Vitrectomy was required in 24% (95% CI: 15 to 31%) of all PDR eyes and was most commonly performed for vitreous haemorrhage (65%). The 10-year survival in all PDR patients was 76% (95% CI: 63 to 85%) with the mean time to death for all deceased patients being 5.4 ± 3.6 years. On multivariable analysis, only age was found to have a significant association with the survival of patients with PDR.
Conclusions:
During the 10 year follow up SVL was uncommon, but MVL occurred in almost one-fifth of the eyes. Approximately 1 in 4 eyes required vitrectomy, highlighting its significance in patient management.
