| Objective: To study the clinic characteristic and causes of the vitreous hemorrhage(VH)after panretinal photocoagulation(PRP)for proliferative diabetic retinopathy in one year.Methods: We analyzed 229 eyes of 121 PDR patients after PRP treatment done by the Second Affiliated Hospital of Nanchang University from October-2013 to March-2015.The age,sex,diabetes mellitus type,course of disease,best corrected visual acuity(BCVA)before PRP and the situation of PVD were recorded.According to the diabetes mellitus type,the cases were divided into two groups.Type 1 diabetes mellitus(T1DM)group with 26 eyes of 13 cases,including 5 males and 8 females(mean age 28.0±4.1 years,mean course of DM 7.4±3.4 years).and Type 2diabetes mellitus(T2DM)group with 203 eyes of 108 cases,including 59 males and 49 females(mean age 53.5±9.8 years,mean course of DM 8.7±4.2 years).The effect on visual acuity was positive when it was improved or kept still.The Vision efficient and the VH incidence rates after the PRP were compared between the two groups.According to the situation of the PVD,the cases in the T2 DM group were divided into two groups,group A and group B.Group A included cases with total PVD.Group B included cases with partial or without PVD.The VH incidence rates after the PRP were compared between the two groups.16 cases underwent 23 G pars plana vitrectomy because of VH.The BCVA and intraocular pressure were recorded before operation.The postoperative patients were followed up for 1-24 months,the BCVA and complications were observed.SPSS 17.0 software package was used for Statistical analysis.Results: 1.After PRP treatment,visual acuity in T1 DM group and T2 DM group was improved or kept still in 24eyes(92.31%)and 196 eyes(96.55%)for the first time of follow-up,There was no significant difference in visual efficient between the two groups(P=0.608).2.PDR patients were followed up for 1 year after PRP treatment and some of them were found suffered from VH.There were 26 eyes in T1 DM group,5 of them suffered from VH.203 eyes in T2 DM group,11 of them suffered from VH.The incidence rate of VH after PRP treatment in T1 DM patients was significantly higher than that in T2 DM patients(P=0.009).3.Among T2 DM group,23 eyes were found total PVD,and 1 eye suffered from VH,with 180 eyes were found partial or without PVD,and 10 of them suffered from VH,There was no significant difference in VH incidence rates between the two groups(P>0.05).4.Vitrectomy was performed for 16 eyes with severe VH.Causes of VH during vitrectomy were observed,14 eyes of them were fibrous vessel membrane and(or)the neovascularization rupture,one of them was the proliferation pull the retinal vessel and another of them without determined reason.5.The patients were followed up for 1 year after PRP treatment,and VH occurred in each time period.4 eyes suffered VH in 3 months after PRP treatment,6 eyes in 3 to 6 months,4 eyes in 6 to 9 months,and 2 eyes in 9 to 12 months.6.After the vitrectomy,the visual acuity of 14 eyes tended to improved in different degrees.Surgical complications included iatrogenic retinal tear in 1 eye,corneal edema in 3 eyes,transient ocular hypertension in 2 eyes and recurrent VH in 1 eye.Conclusion: VH is probable to occur in PDR patients after PRP treatment,T1 DM patients have higher incidence than T2 DM patients.The causes of VH after treatment including fibrous vessel membrane and(or)the neovascularization rupture,and proliferation pulls the retinal vessel will also lead to VH. |
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