title: Prospective assessment of proliferative diabetic retinopathy with observations of posterior vitreous detachment.
abstract: OBJECTIVE
  To study the relation between posterior vitreous detachment (PVD) and progression of diabetic retinopathy (DR), based on our observation that proliferative DR is rare in patients with complete PVD.
  
  
  METHODS
  The medical records of 403 patients with diabetes were reviewed for the relation between progressive DR and the status of PVD and HbA(1c) over 3 years. PVD was classified into none, complete PVD with collapse, complete PVD without collapse, partial PVD with a thickened posterior vitreous cortex, and partial PVD without a thickened posterior vitreous cortex. DR was classified into none, simple, preproliferative, or proliferative. When it became more extensive or when laser treatment or vitreous surgery was performed, the DR was considered progressive.
  
  
  RESULTS
  Progression of DR over 3 years occurred in 128/292 (43.8%) eyes with no PVD, 0/14 (0%) eyes with complete PVD with collapse, 2/8 (25%) eyes with complete PVD without collapse, 15/15 (100%) eyes with partial PVD with a thickened posterior vitreous cortex, and 19/74 (25.7%) eyes with partial PVD without a thickened posterior vitreous cortex. Progression of DR occurred significantly more frequently in eyes with partial PVD with a thickened posterior vitreous cortex compared to eyes with complete PVD with collapse (p<0.0001). HbA(1c), did not differ significantly between these two groups (6.9 +/- 0.9% and 7.5 +/- 0.9%, respectively; p = 0.14), although HbA(1c) was significantly higher (p = 0.04) in patients with progressive DR (78 +/- 1.8%) than in patients without progressive DR (7.5 +/- 1.5%).
  
  
  CONCLUSIONS
  Complete PVD is a strong negative risk factor for DR. The PVD status in patients with diabetes should be evaluated.
authors.affiliation: Department of Ophthalmology, Jichi Medical University, Omiya Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan.
authors.forename: Ryuichiro
authors.initials: R
authors.lastname: Ono
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kakehashi
authors.forename: Hiroko
authors.initials: H
authors.lastname: Yamagami
authors.forename: Norito
authors.initials: N
authors.lastname: Sugi
authors.forename: Nozomi
authors.initials: N
authors.lastname: Kinoshita
authors.forename: Takako
authors.initials: T
authors.lastname: Saito
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tamemoto
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kuroki
authors.forename: San-E
authors.initials: SE
authors.lastname: Lshikawa
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kawakami
mesh_terms: D003930:Diabetic Retinopathy / Q000097:blood / Q000150:complications* / Q000473:pathology; D018450:Disease Progression; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D011379:Prognosis; D011446:Prospective Studies; D018630:Vitreoretinopathy, Proliferative / Q000150:complications* / Q000473:pathology; D014822:Vitreous Body / Q000473:pathology; D020255:Vitreous Detachment / Q000209:etiology* / Q000473:pathology
chemical_list: D006442:Glycated Hemoglobin