Treatment of Vitreous Hemorrhage due to Proliferative Diabetic Retinopathy in Cipto Mangunkusumo Hospital During Pandemic Era (March 2020 - March 2022): Oral Presentation - Observational Study - Resident

Introduction & Objectives
Proliferative diabetic retinopathy (PDR) is the most common etiology for vitreous hemorrhage (VH)
and can be sight-threatening. Current treatment modalities for VH in PDR included anti-VEGF
injection, panretinal photocoagulation (PRP) laser, and vitrectomy. We conducted study to evaluate
treatment modalities and outcomes of VH in PDR during the pandemic era.



Methods
A retrospective study of VH in PDR was conducted at Cipto Mangunkusumo Hospital, Indonesia,
from March 2020 to March 2022. Primary treatment was the therapy planned at the initial visit,
while secondary treatment was subsequent treatment after follow-ups. Good anatomical outcome
was defined as vitreous clearing at last follow-up, while functional outcome was visual acuity (VA)
improvement in LogMAR.



Results
This study included 83 patients (97 eyes), which is smaller than the previous study in our center
before the pandemic. Mean age was 54,28±8,57 years, with almost equal males and females. Initial
VA was LogMAR 2,48 (0,15 – 2,80). The most frequent treatment for VH in PDR was vitrectomy
(53,5%), followed by anti-VEGF injection, PRP laser, and observation. Glaucoma after vitrectomy was
the most common complication (5,2%). Vitreous clearing was achieved in 85,5% of cases, which was
significantly associated with vitrectomy surgery (p=0,013) and initial treatment time (p=0,023). The
VA improvement was LogMAR -0,48(-2,48–2,40) which was related to initial VA (p<0.05), yet there
was no significant association with treatment modality.



Conclusion
Vitrectomy is essential to achieve vitreous clearing in VH caused by PDR. Initial visual acuity, not
the type of treatment modality, is a significant factor in vision improvement.