Risk factors associated with neovascular glaucoma after vitrectomy in eyes with proliferative diabetic retinopathy / 中华眼底病杂志

ABSTRACT

Objective To investigate the risk factors associated with neovascular glaucoma (NVG) after pars plana vitrectomy (PPV) in eyes with proliferative diabetic retinopathy (PDR).Methods Retrospective study.One hundred and thirty-seven patients (137 eyes) with PDR who underwent PPV were recruited.There were 85 males and 52 females.The average age was (60.1 ± 8.8) years old.The duration of diabetes was (10.2 ± 3.6) years.There were 49 patients with ipsilateral carotid artery stenosis.Fifty-three eyes underwent intravitreal ranibizumab or conbercept injection before PPV.All eyes were treated with 23G standard three-port PPV.The average follow-up time after PPV was 11.5 months.Fundus fluorescein angiography (FFA) was conducted in postoperative 4-6 weeks to observe non-perfused retinal areas.Risk factors,such as ipsilateral carotid artery stenosis,the presence of non-perfusion in retina after PPV and the application of anti-vascular endothelial growth factor (VEGF) drugs before PPV,were identified by logistic regression.Results Twenty of 137 patients (14.6％) developed postoperative NVG after PPV.Ipsilateral carotid artery stenosis [odds ratio (OR) =5.048,95％ confidence interval (CI) 2.057-12.389,P=0.000] and the presence of non-perfusion in retina after PPV (OR=4.274,95％CI 1.426-12.809,P=0.009) were significant risk factors for postoperative NVG,while the application of anti-VEGF drugs was not (OR=1.426,95％CI 0.463-4.395,P=0.536).But the time from PPV to the onset of NVG varies significantly between the two groups of injection of anti-VEGF drugs or not (t=-4.370,P=0.000).Conclusions Risk factors associated with NVG after PPV in eyes with PDR included ipsilateral carotid artery stenosis and the presence of non-perfusion in retina after PPV.The application of anti-VEGF drugs before PPV can delay the onset of NVG in PDR eyes after vitrectomy.