Diabetic vitrectomy reflects progression of diabetic retinopathy (DR) to the most severe endpoint. This 5 year audit encompasses all diabetic vitrectomies performed in South Australia (SA) and Northern territory (NT). We aimed to identify risk factors predisposing to diabetic vitrectomy in SA and NT.
Vitrectomies performed in public and private hospitals in SA and NT between 2007 and 2011 were identified. Medical records were audited and data collected, for all patients who required vitrectomy for diabetic complications.† Data collected included demographics, ethnicity, diabetic history, past treatment for DR, visual acuity, and the indication for vitrectomy.
458 diabetic vitrectomies, for 310 patients were performed in SA and NT between 2007 and 2011. 73 (23.5%) patients requiring diabetic vitrectomy were Indigenous Australians. Mean age at diabetes diagnosis was lower in Indigenous (37.10 ±10.31) compared with non-Indigenous (43.95 ±13.18) patients (p=0.001). †In multivariate survival analyses from diabetes onset to vitrectomy, younger age of diabetes onset (P<0.001; OR: 0.96; CI: 0.95-0.98) and Indigenous Australian ethnicity (P=0.04; OR: 1.68; CI: 1.02-2.77) were both independently associated with earlier vitrectomy. Survival analysis from onset of proliferative DR (PDR) found Indigenous Australian ethnicity (P=0.025; OR: 1.58; CI: 3.26-7.29) and lack of previous laser (P=0.003; OR: 0.58; CI: 1.24-2.55) to be associated with earlier vitrectomy.
Indigenous Australians are over represented in the subset of diabetic patients reaching diabetic vitrectomy in SA and NT. Multiple factors including earlier age of diabetes onset, and lack of previous laser treatment predispose to earlier vitrectomy.