| Objective:To investigate the risk factors of the first primary vitreous hemorrhage(PVH)caused by type 2 diabetic retinopathy(DR),and to discuss the different prognosis of PVH induced by type 2 DR fro m the perspective of treatment,and to provide support for clinical treatment and prognosis evaluation.Methods :(1)Clinical data of 179 patients with type 2 DR admitted to the Department of Ophthalmology,Second Affiliated Hospital of Chongqing Medical Univers ity from September 2015 to September 2017 were selected.General data inc luded gender,age,duration of illness,education level,smoking and drinking;The clinical data inc lude fasting plasma glucose(FPG),2 hours postprandial blood glucose(2H PG),and glycosylated hemoglobin(Hb A1C),diastolic pressure(DBP),systolic blood pressure(SBP),Urea,Creatinine(Cre),Triglyceride(TG),Total cholesterol(TC),High density lipoprotein-cholesterol(HDL),Low density cholesterol(LDL)etc.(2)According to the disease course,all cases were divided into non-proliferative diabetic retinopathy(NPDR)group and proliferative diabetic retinopathy(PDR).Learn the possible risk factors for DR progression to PDR group.(3)According to the characteristics of the eye,the patients were divided into PVH group(with any PVH in one eye)and non-PVH group,and the independent risk factors causing PVH were further explored.(4)For the PVH group,treatment was divided into surgery group(vitrectomy)and non-surgery group(enough treatment with conservative treatment and retinal laser),The best corrected visual acuity compared between the first day after surgery and non-surgical group enough to cure.Predicted the efficacy of the two treatment methods.Results:(1)Age,course of disease,SBP,DBP,FPG,Hb A1 C,UREA,CRE,TG,TC,HDL,and LDL were statistically significant between NPDR group and PDR group(P < 0.05).There was no significant difference in gender,education level,smoking,drinking and postprandial 2H PG(P > 0.05).(2)Age,SBP,DBP,FPG,Hb A1 C,CRE,TG,TC,HDL,LDL were all statistically significant between PVH group and non-PVH group(P<0.05),gender,disease duration,education level,smoking,drinking,meal After 2 hours of PG and UREA were not statistically significant(P>0.05).In binary logistic regression analys is,Hb A1 C was an independent risk factor for DR-induced PVH,and HDL was a protective factor.(3)Concerning the treatment of DR-induced PVH,in the surgical group,the best corrected visual acuity on the first postoperative day after vitrectomy was significantly(38.9%),effective(13.6%)only.There were 7.3% that was ineffective,and the total effective rate was 92.7%.In the non-surgery group,the best corrected visual acuity what measured after 7-10 days of treatment with improved circulating medication and retina laser was significantly effective(29.5%),(61.4%)was valid,(9.1%)was invalid,and the total effective rate was 90.9%.After the total effic iency of the two groups was tested by the Chi-square,there were statistical significance(Z=-3.554,P<0.05).(4)Comparing the complications of PVH with different treatment regimens,2(3.6%)eyes had vitreous cavity rebleeding,11(20%)eyes had cataract,3(5.5%)eyes only secondary In glaucoma,retinal detachment was secondary to 2(3.6%)eyes;in the non-surgical group there were 10(22.7%)eyes with vitreous cavity rebleeding,1(2.3%)eyes with cataract,1(2.3%)only In secondary glaucoma,5(11.4%)eyes had secondary retinal detachment.All complications were statistically significant between groups(P<0.05).Conclusions:(1)Age,disease duration,SBP,DBP,FPG,Hb A1 C,UREA,CRE,TG,TC,HDL,and LDL may be the risk factors of PDR;Hb AlC is an independent risk factor,HDL is a protective factors in PVH caused by DR group.(2)Vitrectomy and conservative treatment with adequate duration of care both can improve the visual acuity of patients with PVH caused by DR.As for surgery,the best corrected visual acuity is more significant,and fewer serious complications.In the long-term,surgical treatment can Improve vis ion to a greater extent and improve the quality of life of patients. |
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