Effect of Lens Status on Diabetic Vitreous Hemorrhage Resolution

Abstract

Purpose: To determine the effect of lens status (pseudophakic vs phakic) on diabetic vitreous hemorrhage (VH) resolution time. Methods: Medical records were reviewed retrospectively for each case of diabetic VH until resolution, pars plana vitrectomy (PPV), or loss to follow-up. Univariate and multivariate Cox regression models were used to determine predictors of diabetic VH resolution time through estimated hazard ratios (HRs). Kaplan-Meier survival analysis compared differences in the resolution rate by lens status and other significant factors. Results: Overall, 243 eyes were included. Pseudophakia (HR, 1.76; 95% CI, 1.07-2.90; P = .03) and prior PPV (HR, 3.28; 95% CI, 1.77-6.07; P < .001) were significant factors for faster resolution. Pseudophakic eyes resolved in 5.5 months (median, 25.1 weeks; 95% CI, 19.3-31.0) and phakic eyes in 10 months (median, 43.0 weeks; 95% CI, 36.0-50.0) ( P = .001). More pseudophakic eyes than phakic eyes resolved without PPV (44.2% vs 24.8%) ( P = .001). Eyes without prior PPV resolved in 9.5 months (median, 41.0 weeks; 95% CI, 35.7-46.3) compared with 5 months (median, 22.3 weeks; 95% CI, 9.8-34.8) in vitrectomized eyes ( P < .001). Age, treatment with antivascular endothelial growth factor injections or panretinal photocoagulation, intraocular pressure medications, and glaucoma history were not significant predictors. Conclusions: Diabetic VH resolved almost twice as fast in pseudophakic eyes than in phakic eyes. Eyes with a history of PPV resolved 3 times quicker than those without PPV. A better understanding of VH resolution can help personalize the decision on when to proceed with PPV.