Clinical Features and Surgical Outcomes of Subretinal Proliferation in Proliferative Diabetic Retinopathy

Background: To investigate the clinical characteristics, treatments and prognosis of subretinal proliferation (SRP) in patients with proliferative diabetic retinopathy (PDR).Methods: 154 patients (182 eyes) who received vitrectomy for PDR were retrospectively reviewed. Patients with SRP were enrolled as the study group, and those without SRP served as the control group. The following data were collected from their medical records: demographics, systemic and ophthalmologic findings, and treatment given specifically for SRP. The main outcome measures included the visual acuity, funduscopic examination and final anatomic success. The association between SRP and other systemic involvement of PDR was also analyzed. Results: There were 9 eyes (9 patients) in the study group and 145 eyes (145 patients) in the control group. The average fasting blood glucose was 11.48 ± 3.52 mmol/L and 8.72 ± 3.05 mmol/L, respectively (P = .048). The study group had a significantly higher proportion of tractional retinal detachment (TRD) (P < .0001) and a significantly lower proportion of vitreous hemorrhage (VH) (P = .0006). The rate of silicone oil usage was higher in the study group (P < .0001). No retinal break was found preoperatively or intraoperatively. Only one eye (11.1%) had undergone subretinal band removal procedure intraoperatively, and the final anatomical success rate was 100%. Conclusion: SRP in PDR was associated with higher blood sugar levels and TRD. The retina could reattach successfully after vitrectomy without removal or transection of the subretinal bands in most eyes.