Korean journal of ophthalmology : KJO · 2026
Preoperative Clinical Factors Associated with Occult Fibrovascular Proliferation or Tractional Retinal Detachment in Diabetic Vitreous Hemorrhage.
СтатьяНазвание и аннотация: Перевод в очереди
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Park Sang A, Jung Hyun Ji, Kim Hyun Jin, Cho Soo Chang
Аннотация
PURPOSE: To investigate preoperative clinical factors associated with occult tractional pathology identified intraoperatively during pars plana vitrectomy (PPV) for dense proliferative diabetic retinopathy (PDR)-related vitreous hemorrhage (VH) with limited preoperative fundus visibility.
METHODS: This single-center retrospective study included eyes that underwent PPV for dense PDR-related VH between March 2019 and February 2026. Eyes with indeterminate preoperative fibrovascular proliferation (FVP) or tractional retinal detachment (TRD) status were included and classified intraoperatively as either simple VH or VH with FVP/TRD (i.e., occult tractional pathology). Preoperative demographic and clinical variables were analyzed using univariable and multivariable generalized estimating equation (GEE) logistic regression models.
RESULTS: Of 87 included eyes (simple VH, n = 61; VH with FVP/TRD, n = 26), the VH with FVP/TRD group was younger (52.9 ± 10.8 vs. 58.6 ± 11.4 years; p = 0.034) and had higher glycated hemoglobin (HbA1c; 8.2% [7.1-9.6] vs. 6.8% [6.1-8.1]; p = 0.010). On univariable analysis, younger age (odds ratio [OR], 0.956; 95% confidence interval [CI], 0.917-0.997; p = 0.034) and higher HbA1c (OR, 1.373; 95% CI, 1.068-1.765; p = 0.013) were each significantly associated with VH with FVP/TRD. On multivariable analysis, higher HbA1c was the only associated factor with VH with FVP/TRD (adjusted OR, 1.332; 95% CI, 1.022-1.736; p = 0.034), whereas younger age did not reach statistical significance (adjusted OR, 0.967; 95% CI, 0.926-1.011; p = 0.137). Preoperative fellow-eye status was not significantly associated with VH with FVP/TRD.
CONCLUSIONS: Higher HbA1c was associated with occult tractional pathology in dense PDR-related VH, whereas younger age showed a non-significant directional association. In patients with dense PDR-related VH and limited fundus visibility, elevated preoperative HbA1c may serve as a supportive clinical factor for identifying eyes at higher risk of occult tractional pathology and may aid preoperative risk stratification and surgical planning.
METHODS: This single-center retrospective study included eyes that underwent PPV for dense PDR-related VH between March 2019 and February 2026. Eyes with indeterminate preoperative fibrovascular proliferation (FVP) or tractional retinal detachment (TRD) status were included and classified intraoperatively as either simple VH or VH with FVP/TRD (i.e., occult tractional pathology). Preoperative demographic and clinical variables were analyzed using univariable and multivariable generalized estimating equation (GEE) logistic regression models.
RESULTS: Of 87 included eyes (simple VH, n = 61; VH with FVP/TRD, n = 26), the VH with FVP/TRD group was younger (52.9 ± 10.8 vs. 58.6 ± 11.4 years; p = 0.034) and had higher glycated hemoglobin (HbA1c; 8.2% [7.1-9.6] vs. 6.8% [6.1-8.1]; p = 0.010). On univariable analysis, younger age (odds ratio [OR], 0.956; 95% confidence interval [CI], 0.917-0.997; p = 0.034) and higher HbA1c (OR, 1.373; 95% CI, 1.068-1.765; p = 0.013) were each significantly associated with VH with FVP/TRD. On multivariable analysis, higher HbA1c was the only associated factor with VH with FVP/TRD (adjusted OR, 1.332; 95% CI, 1.022-1.736; p = 0.034), whereas younger age did not reach statistical significance (adjusted OR, 0.967; 95% CI, 0.926-1.011; p = 0.137). Preoperative fellow-eye status was not significantly associated with VH with FVP/TRD.
CONCLUSIONS: Higher HbA1c was associated with occult tractional pathology in dense PDR-related VH, whereas younger age showed a non-significant directional association. In patients with dense PDR-related VH and limited fundus visibility, elevated preoperative HbA1c may serve as a supportive clinical factor for identifying eyes at higher risk of occult tractional pathology and may aid preoperative risk stratification and surgical planning.