Long-Term Mortality in Diabetic Patients with Tractional Retinal Detachments

Purpose: To determine the long-term, all-cause mortality rate of diabetic patients requiring vitrectomy surgery for tractional retinal detachment (TRD). Design: Institutional review boardeapproved, retrospective, comparative study. Participants: Four hundred eyes of 316 patients undergoing vitrectomy surgery from 2005 to 2015. Methods: Long-term, all-cause mortality rates in the study population were compared with mortality in a historical control group of diabetic patients with minimal to no retinopathy. Subgroup analysis was done based on bilaterality of TRD and initial vision. Other concurrent associated diabetic comorbidities, use of insulin, and type 1 diabetes are also reported. Data were used to create Kaplan-Meier survival curves. Main Outcome Measure: Long-term, all-cause mortality rate of diabetic patients undergoing vitrectomy surgery from 2005 to 2015. Results: Mean survival after diagnosis of TRD requiring vitrectomy surgery was 2.7 years (median, 2 years; range, 0.17e9.00 years). Kaplan-Meier survival curve analysis revealed a 48.7% (154/316 patients) long-term, allcause mortality rate for diabetics requiring vitrectomy surgery for TRDs at 10 years, compared with a mean 2% long-term, all-cause mortality rate in diabetics with minimal to no retinopathy. Subgroup analysis of those patients with bilateral TRDs requiring surgery revealed a 48.9% mortality rate with a mean survival after diagnosis of TRD of 2.6 years (median, 2 years; range, 0.25e9.00 years). Those patients with count fingers or worse vision in one or both eyes at diagnosis had a 52.0% mortality rate (P < 0.05), with a mean survival after diagnosis of 2.6 years (median, 2 years; range, 0.17e9.00 years). Conclusions: In our population, diabetic patients with TRDs requiring surgery have a 48.7% long-term, all-cause mortality rate, with those presenting with count fingers or worse vision having a higher mortality rate. Diabetic TRD requiring vitrectomy surgery is a marker of poor long-term survival. Ophthalmology Retina 2017;1:8-11 a 2016 by the American Academy of Ophthalmology