RHEGMATOGENOUS RETINAL DETACHMENT IN DIABETIC PATIENTS
G.W. Nietgen, L. Hesse
Background: Retinal detachment (RD) in diabetics with proliferative diabetic vitreoretinopathy (PDVR) can be tractional or rhegmatogenous. In this study we elucidate the relationship between rhegmatogenous RD and non-PDVR.
Methods: Files from 847 patients (881 eyes) which underwent vitreoretinal surgery at the Department of Ophthalmology between 1986 and 1994 were investigated. Multifactorial data anaIysis was performed.
Results: In 742 eyes (84.3%) a rhegmatogenous RD without diabetic history was seen. 151 patients (168 eyes) were diabetics. In 138 eyes (82%) with PDVR, exclusively tractional RDs were diagnosed. A rhegmatogenous RD was seen in 18 eyes of diabetics (10.7%) without any signs of diabetic retinopathy. In 7 out of 12 eyes with NPDVR (4.2%) RD was caused by a retinal hole, the other 5 eyes showed a mixed state of tractional and rhegmatogenous RD. Overall, 14.9% of diabetic eyes with RD (n=25) showed solely rhegmatogenous RDs. Other risk factors in this group were high myopia (3/25) and in other eyes pseuophakia (6/25). In all 25 eyes reattachment of the retina was achieved by: vitrectomy with gas (n=1), by circumferential buckle (n=9), by radial buckle or by limbus parallel buckle surgery.
Conclusions: Besides determining diabetic changes in fundoscopy an intensive examination of peripheral retinal areas in diabetics is indicated since degenerative changes with RD can occur. Degenerative changes at the vitreoretinal border might be responsible for rhegmatogenous RDs in diabetics. However, when this population was compared to patients without diabetes no significantly enhanced occurrence of rhegmatogenous RDs was observed.
Department of Ophthalmology, Philipps University, 35037 Marburg, Germany