增殖性糖尿病视网膜病变合并玻璃体出血的临床特点分析

Reyno Satria Ali, A. Victor, A. Djatikusumo, Gitalisa Andayani, Anggun Rama Yudanta, Mario Marbungaran Hutapea
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引用次数: 0

摘要

简介:增殖性糖尿病视网膜病变是成人失明的最常见原因。在玻璃体出血的治疗中,玻璃体切除术是主要的选择,激光光凝治疗联合或不联合抗vegf治疗作为辅助治疗。本研究旨在确定Cipto Mangunkusumo医院玻璃体出血PDR患者的患者人数、人口统计学特征、诊所、危险因素、治疗分布和治疗结果。方法:本研究为回顾性描述性研究,于2020年1月至2022年10月对符合纳入标准的患者进行研究。本研究的人群为Cipto Mangunkusumo医院的PDR伴玻璃体出血患者。表中显示的数据根据数据类型分别为平均值(标准差)和数字(百分比)。结果:146例诊断为增殖性糖尿病视网膜病变(PDR)合并玻璃体出血。大多数受试者为男性(60.9%),诊断为糖尿病10年以上(63.3%),并伴有其他系统性危险因素。最常见的临床特征为初次就诊时视力<3/60(80,8%),诊断为晶状体(78,9%),视网膜脱离(85,3%),2级玻璃体出血(80,8%)。大多数眼行玻璃体切除术(90,44%),抗vegf注射(22,92%),激光PRP(11,46%),玻璃体切除术前后超声乳化术作为辅助治疗。玻璃体切除术后玻璃体状态清晰(99.1%)。玻璃体切除前平均视力为2.10(1.80 ~ 2.50),玻璃体切除后平均视力为1.00(1.30 ~ 2.40),初始和最终视力差为-0.10(-0.50 ~ 0.60)。结论:大多数研究对象为年龄在25-77岁的男性。以玻璃体切除术为主,联合玻璃体内注射抗vegf,激光PRP辅助治疗。在几乎所有的病例中,玻璃体切割治疗后玻璃体出血清除。视力在玻璃体切除术后显示进步,即使在某些情况下没有改善。
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CLINICAL CHARACTERISTICS OF PROLIFERATIVE DIABETIC RETINOPATHY (PDR) PATIENTS WITH VITREOUS HEMORRHAGE AT CIPTO MANGUNKUSUMO HOSPITAL
Introduction: Proliferative Diabetic retinopathy is the most common cause of blindness in adults. In the management of vitreous hemorrhage, vitrectomy is the main choice and also laser photocoagulation with or without anti-VEGF administration as additional therapy. This study aims to determine the number of patients, demographic characteristics, clinics, risk factors, distribution of treatment, and treatment outcomes for PDR patients with vitreous hemorrhage at Cipto Mangunkusumo Hospital. Methods: This study was retrospective descriptive study conducted from January 2020 to October 2022 who met the inclusion criteria. Population in this study were patients at Cipto Mangunkusumo Hospital with PDR accompanied by vitreous hemorrhage. Data shown in the table were mean (standard deviation) and number (percentage) based on the type of the data. Result: A total of 146 patients with the diagnosis of Proliferative Diabetic Retinopathy (PDR) with vitreous hemorrhage. Majority of subjects were men (60,9%), diagnosed with DM more than 10 years (63,0%) with another systemic risk factor. The most common clinical characteristics found visual acuity at the initial visit <3/60 (80,8%), diagnosed phakia (78,9%), retinal detachment (85,3%), grade 2 vitreous hemorrhage (80,8%). The majority of eyes underwent vitrectomy (90,44%), Anti-VEGF injections (22,92%), Laser PRP (11,46 %), Phacoemulsification pre and post- vitrectomy as adjuvant treatment. The condition of the vitreous was clear after vitrectomy (99,1%). Mean visual acuity before vitrectomy is 2.10 (1.80 – 2.50), while mean visual acuity after vitctomy was 1.00 (1.30 – 2.40), with a difference in initial and final visual acuity of -0.10 (-0.50 – 0.60). Conclusion: Majority of study subjects were men with an age range of 25-77 years. Vitrectomy as the main treatment combined with intravitreal injection of anti-VEGF, laser PRP as adjuvant treatment. In nearly all cases, vitreous hemorrhage was clear after vitrectomy treatment. Visual acuity after vitrectomy shows progress even though in some cases there was no improvement.
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