High BMI, silicone oil tamponade, and recurrent vitreous hemorrhage predict poor visual outcomes after pars plana vitrectomy in proliferative diabetic retinopathy.

Abstract

Background: Proliferative diabetic retinopathy (PDR) is a serious microvascular complication of diabetes and a leading cause of global vision loss. Pars plana vitrectomy (PPV) is the primary surgical treatment for PDR, but visual outcomes vary due to multiple influencing factors. This study aims to evaluate the factors predicting visual prognosis in patients with PDR after PPV.

Methods: A retrospective analysis was performed on 112 eyes from 87 patients with PDR who underwent PPV between May 2020 and May 2024. Data collected included patient demographics, preoperative and postoperative best-corrected visual acuity (BCVA), and other baseline clinical data. Data analysis was performed with IBM SPSS Statistics Version 24.0. Univariate and multivariate linear regression models were applied to assess the relationship between the final BCVA and various clinical parameters.

Results: The mean BCVA improved significantly, from 1.94 ± 0.89 logMAR preoperative to 0.76 ± 0.70 logMAR postoperatively (P < 0.001). Multivariate linear regression identified body mass index (BMI) (B = 0.035; 95% CI 0.003-0.066; P = 0.033), silicone oil (SO) tamponade (B = 0.354; 95% CI 0.005-0.643; P = 0.029), and recurrent vitreous hemorrhage (VH) (B = 0.585; 95% CI 0.304-0.867; P < 0.001) as significant negative predictors of final BCVA.

Conclusions: While PPV improves visual outcomes in PDR patients, factors such as high BMI, SO tamponade, and recurrent VH negatively affect prognosis and could serve as predictors of poor visual outcomes following the procedure. This study emphasizes the importance of tailored management strategy for PDR, including early intervention, optimal BMI control, and minimizing SO tamponade duration.