Differential Distribution of Fibrovascular Proliferative Membranes in 25-Gauge Vitrectomy for Proliferative Diabetic Retinopathy

Abstract

Purpose: To analyze the distribution of fibrovascular proliferative membrane (FVPM) in proliferative diabetic retinopathy (PDR) patients that need treated with pars plana vitrectomy (PPV), and to evaluate the outcomes separately. Methods: Retrospective review of consecutive 25-G PPV cases operated for PDR between September 2018 and April 2020. All FVPMs were outlined and assigned to three groups: arcade type, juxtapapillary type and central type. General characteristics, operation-related variables, best-corrected visual acuity (BCVA) 12 month postoperative and complications were recorded. , All patients were followed up for over one year Results: In total, 93 eyes were recruited. Among them, the FVPMs distribution of nasotemporal and inferiosuperioral were significantly different (both p < 0.01), with 87 (93.55%) FVPMs located in the nasal hemispheres, and 67 (72.04%) in the inferior hemispheres. The eyes with a central FVPM required the longest operation time, with silicon oil used in most patients, generally combined with tractional retinal detachment (RD) and rhegmatogenous RD, as well as the worst postoperative best-corrected visual acuity and the highest rates of recurrent RD and iatrogenic retinal break formation (all p < 0.05). Conclusion: FVPMs were more commonly found in the nasal and inferior mid-peripheral retina in addition to the area of arcade vessels. Performing 25-G PPV for treating PDR eyes with a central FVPM had a relatively worse prognosis.