title: A proposed new classification for diabetic retinopathy: the concept of primary and secondary vitreopathy.
abstract: BACKGROUND
  Many eyes with proliferative diabetic retinopathy (PDR) require vitreous surgery despite complete regression of new vessels with pan retinal laser photocoagulation (PRP). Changes in the vitreous caused by diabetes mellitus and diabetic retinopathy may continue to progress independent of laser regressed status of retinopathy. Diabetic vitreopathy can be an independent manifestation of the disease process.
  
  
  OBJECTIVE
  To examine this concept by studying the long-term behavior of the vitreous in cases of PDR regressed with PRP.
  
  
  METHODS
  Seventy-four eyes with pure PDR (without clinically evident vitreous traction) showing fundus fluorescein angiography (FFA) proven regression of new vessels following PRP were retrospectively studied out of a total of 1380 eyes photocoagulated between March 2001 and September 2006 for PDR of varying severity. Follow-up was available from one to four years.
  
  
  RESULTS
  Twenty-three percent of eyes showing FFA-proven regression of new vessels with laser required to undergo surgery for indications produced by vitreous traction such as recurrent vitreous hemorrhage, tractional retinal detachment, secondary rhegmatogenous retinal detachment and tractional macular edema within one to four years.
  
  
  CONCLUSIONS
  Vitreous changes continued to progress despite regression of PDR in many diabetics. We identifies this as "clinical diabetic vitreopathy" and propose an expanded classification for diabetic retinopathy to signify these changes and to redefine the indications for surgery.
authors.affiliation: Dr Dubey's Retina Centre, Gwalior, India. adubey56@sify.com
authors.forename: Arvind Kumar
authors.initials: AK
authors.lastname: Dubey
authors.forename: Pran Nath
authors.initials: PN
authors.lastname: Nagpal
authors.forename: Shobhit
authors.initials: S
authors.lastname: Chawla
authors.forename: Benu
authors.initials: B
authors.lastname: Dubey
mesh_terms: D000328:Adult; D003930:Diabetic Retinopathy / Q000145:classification* / Q000473:pathology / Q000601:surgery; D018450:Disease Progression; D005260:Female; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D018630:Vitreoretinopathy, Proliferative / Q000145:classification* / Q000473:pathology / Q000601:surgery; D014822:Vitreous Body