title: Vitrectomy for complications of proliferative diabetic retinopathy in young adults: clinical features and surgical outcomes.
abstract: OBJECTIVE
  To investigate the clinical manifestations and surgical results after vitrectomy for proliferative diabetic retinopathy (PDR) in young patients.
  
  
  METHODS
  Clinical features of patients between 18 to 40 years old who received vitrectomy for PDR between January 2009 and January 2015 were retrospectively reviewed. Those older than 40 years who received vitrectomy for PDR during the same period were retrospectively enrolled and compared as the control group.
  
  
  RESULTS
  There were 68 eyes (52 patients) in the study group and 77 eyes (61 patients) in the control group. The average age at operation was 33.15 ± 4.92 years and 56.67 ± 7.52 years, respectively (p < 0.001). At presentation, those in the study group had significantly higher proportions of active fibrovascular proliferation and traction retinal detachment, and with significantly higher-severity gradings than those in the control group. After operation, the recurrent detachment rates were 13.2% in the study group and 1.3% in the control group (p = 0.006), and the final anatomical success rates were 91.2% in the study group and 100% in the control group (p = 0.009). The most significant risk factor for poor visual outcome in the study group was neovascular glaucoma (NVG) (p = 0.001). Patients with Type 1 and Type 2 diabetes mellitus subgroups shared similar clinical features and visual outcome.
  
  
  CONCLUSIONS
  Younger patients who received vitrectomy for PDR presented with more severe anatomical features at the time of vitrectomy and had a higher rate of post-operative recurrent detachment. More than 90% achieved final anatomical success. NVG was associated with worse visual outcome.
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chu-Hsuan
authors.initials: CH
authors.lastname: Huang
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.|Department of Ophthalmology, National Taiwan University College of Medicine, No. 7, Chun-Shan S. Rd., Taipei City, 100, Taiwan.
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Hsieh
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan. chungmay@ntu.edu.tw.|Department of Ophthalmology, National Taiwan University College of Medicine, No. 7, Chun-Shan S. Rd., Taipei City, 100, Taiwan. chungmay@ntu.edu.tw.
authors.forename: Chung-May
authors.initials: CM
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D003930:Diabetic Retinopathy / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D055815:Young Adult
keywords: Fibrovascular proliferation; Neovascular glaucoma; Proliferative diabetic retinopathy; Traction retinal detachment; Type I diabetes mellitus; Younger-onset type II diabetes mellitus