Referrals for proliferative diabetic retinopathy from two UK diabetic retinopathy screening services: a 10-year analysis of visual outcomes, requirement for vitrectomy, and mortality

Salman Naveed Sadiq; Chan Ning Lee; Ben Charmer; Emily Jones; Maged S Habib; Maria T Sandinha; Ticiana Criddle; David H W Steel

doi:10.1038/s41433-024-03078-1

Referrals for proliferative diabetic retinopathy from two UK diabetic retinopathy screening services: a 10-year analysis of visual outcomes, requirement for vitrectomy, and mortality

Eye (Lond). 2024 Apr 23. doi: 10.1038/s41433-024-03078-1. Online ahead of print.

Authors

Salman Naveed Sadiq¹, Chan Ning Lee², Ben Charmer¹, Emily Jones², Maged S Habib^{1

3}, Maria T Sandinha^{2

4}, Ticiana Criddle², David H W Steel^{5

6}

Affiliations

¹ Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, SR2 9HP, UK.
² St. Paul's Eye Unit, The Royal Liverpool University Hospital, Liverpool, UK.
³ Biosciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
⁴ Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.
⁵ Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, SR2 9HP, UK. david.steel@ncl.ac.uk.
⁶ Biosciences Institute, Newcastle University, Newcastle Upon Tyne, UK. david.steel@ncl.ac.uk.

PMID: 38653749
DOI: 10.1038/s41433-024-03078-1

Abstract

Background/objectives: To determine long-term outcomes of patients referred with proliferative diabetic retinopathy (PDR) from diabetic eye screening programmes (DESP) to tertiary care centres in the United Kingdom (UK).

Methods: Retrospective multicentre study of patients referred from two DESPs in the UK over a 36-month period (2007-9) and followed-up for 10 years. Critical outcomes included severe vision loss (SVL) and the need for vitrectomy. Other outcomes assessed included moderate vision loss (MVL), and patient survival time. Univariate and multiple variable Cox proportional hazards regressions were used to analyse survival outcomes.

Results: 212 eyes of 150 patients were referred with a diagnosis of PDR. 109 eyes of 72 patients were confirmed to have active PDR and included in the study. 61% of patients had low-risk PDR, while 39% exhibited high-risk features in at least one eye. Eight (7.3%) eyes developed SVL and 16 (14.7%) MVL during follow up. Vitrectomy was required in 24% (95% CI: 15 to 31%) of all PDR eyes and was most commonly performed for vitreous haemorrhage (65%). The 10-year survival in all PDR patients was 76% (95% CI: 63 to 85%) with the mean time to death for all deceased patients being 5.4 ± 3.6 years. On multivariable analysis, only age was found to have a significant association with the survival of patients with PDR.

Conclusions: During the 10 year follow up SVL was uncommon, but MVL occurred in almost one-fifth of the eyes. Approximately 1 in 4 eyes required vitrectomy, highlighting its significance in patient management.