title: Clinical variables and their relation to visual outcome after vitrectomy in eyes with diabetic retinal traction detachment.
abstract: BACKGROUND
  To analyse vitrectomy results in diabetic eyes with retinal traction detachment and to investigate which variables are associated with a worse visual outcome.
  
  
  METHODS
  Forty-four diabetic eyes (33 patients) with central retinal traction detachment were analyzed retrospectively.
  
  
  RESULTS
  After a median follow-up of 10 months, median visual acuity significantly improved from 20/800 to 20/160 (P=0.02), despite the fact that the majority of patients had a long-standing macular traction detachment (median 120 days). Twenty-two eyes (50%) achieved a visual acuity of >20/200. The retina was finally reattached in 38 eyes (86.3%). Univariate analysis showed that patients with type 2 diabetes, age older than 50 years, preoperative visual acuity <20/200, iris neovascularisation and macular detachment of >30 days had a significantly worse final visual outcome. After multiple logistic regression analysis, age and iris neovascularisation were the strongest predictors of a worse visual outcome; if both were present, the chance of a obtaining a visual outcome of <20/200 was almost 90%.
  
  
  CONCLUSIONS
  Age and iris neovascularisation were the strongest predictors for a low visual outcome. In a review of vitrectomy studies in eyes with severe diabetic traction detachment in the past 2 decades, we found a trend towards higher anatomic success rates, while visual outcome only slightly improved. The current study confirmed the importance of ophthalmic variables, but also indicates the importance of evaluating systemic variables in larger series in order to predict which eyes may truly benefit from vitrectomy.
authors.affiliation: Department of Ophthalmology, University Hospital Maastricht, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. ela@soog.azm.nl
authors.forename: Ellen C
authors.initials: EC
authors.lastname: La Heij
authors.forename: Sadettin
authors.initials: S
authors.lastname: Tecim
authors.forename: Alfons G H
authors.initials: AG
authors.lastname: Kessels
authors.forename: Albert T A
authors.initials: AT
authors.lastname: Liem
authors.forename: Wouter J
authors.initials: WJ
authors.lastname: Japing
authors.forename: Fred
authors.initials: F
authors.lastname: Hendrikse
mesh_terms: D000328:Adult; D000367:Age Factors; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D007498:Iris / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000150:complications; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy