Visual function assessment after vitrectomy for severe proliferative diabetic retinopathy

Abstract:

AIM: To assess the visual function prognosis after vitrectomy for patients with proliferative diabetic retinopathy(PDR)at stage Ⅵ and the impacting factors and to evaluate visual function using multifocal electroretinogram(mfERG).

METHODS: One hundred and thirteen cases(130 eyes)with PDR at stage VI treated with standard vitreoretinal surgery were retrospectively analyzed. According to the OCT examination before surgeries and ocular fundus during surgeries, the reviewed cases were divided into two groups: patients with traction retinal detachment and maculopathy(99 cases with 113 eyes)and without maculopathy(14 cases with 17 eyes). Eyes underwent OCT and mfERG examination. Visual acuity preoperative and postoperative, mfERGP1 wave amplitudes, morphology features of macular,complications and prognoses were analyzed.

RESULTS: The rate of improved visual acuity postoperatively was 63.1%(82/130). The vision was 0.05 or better in 19 eyes(14.6%)preoperatively, and in 61 eyes(46.9%)postoperatively, in which the vision of 56 eyes were >0.1. In patients without maculopathy, the rate of visual improvements were 88.2% and there were 94.1% with the vision >0.1, which were both better than patients with significant maculopathy group(59.3% and 35.4%), and the differences were significant(P<0.05).The amplitude densities of P1 wave in the 6 rings were markedly increased after vitrectomy, and they turned to be better with time(P<0.05).The amplitude densities of P1 wave in rings(1+2)of eyes without maculopathy were higher than eyes with maculopathy(P<0.05).

CONCLUSION: The visual function of eyes with PDR at stage VI is improved after vitrectomy. The amplitude densities of P1 wave in the 6 rings increase markedly after vitrectomy, and they turn to be better with time. The improvement of visual function in severe PDR without maculopathy group is better than that in severe PDR with maculopathy group after vitrectomy.

Key words:severe proliferative diabetic retinopathy; vitrectomy; multifocal electroretinogram; visual function; maculopathy