Prevalence of Vitreous Hemorrhage Following Coronary Revascularization in Patients With Diabetic Retinopathy

• Published in: Circulation Journal 2011, Vol.75(2), pp.329-335
• Main Authors: Kawashima, Dai, Ohno, Takayuki, Kinoshita, Osamu, Motomura, Noboru, Kiyosue, Arihiro, Fujita, Hideo, Ando, Jiro, Ohtomo, Kazuyoshi, Shigeeda, Takashi, Kato, Satoshi, Kadowaki, Takashi, Nagai, Ryozo, Takamoto, Shinichi, Ono, Minoru
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty, Balloon, Coronary; Coronary Artery Bypass; Coronary artery bypass surgery; Coronary Disease - surgery; Coronary Disease - therapy; Coronary revascularization; Diabetic Angiopathies - surgery; Diabetic Angiopathies - therapy; Diabetic retinopathy; Diabetic Retinopathy - complications; Disease Susceptibility; Drug-eluting stent implantation; Drug-Eluting Stents; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Myocardial Revascularization; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Prevalence; Proportional Hazards Models; Quality of Life; Vitreoretinopathy, Proliferative - complications; Vitreous hemorrhage; Vitreous Hemorrhage - epidemiology; Vitreous Hemorrhage - etiology; Vitreous Hemorrhage - prevention & control
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-10-0404

Background: In patients with diabetic retinopathy (DR), vitreous hemorrhage (VH) is a common complication that threatens visual acuity and hence, quality of life. A considerable number of DR patients at risk of VH require coronary revascularization, but little is known about the prevalence of VH after coronary revascularization.Methods and Results: This study investigated 151 patients with DR who were followed up by ophthalmologists between April 2004 and September 2008, and underwent coronary revascularization (coronary artery bypass surgery n=36 or drug-eluting stent implantation n=115). At the time of coronary revascularization 56 had non-proliferative DR (NPDR) and 95 had proliferative DR (PDR). During an average follow-up of 531 days after revascularization, VH occurred in 24 (15.9%) patients, 18 (11.9%) of whom experienced VH within 6 months of the procedure. In VH patients, PDR rather than NPDR predominated as the background to VH (21 vs. 3, respectively). The 1-year prevalence of VH was higher in patients with PDR than in those with NPDR (22.0% vs. 1.9%, P=0.0055).Conclusions: VH is not a rare complication following coronary revascularization among patients with DR, especially in those with PDR. Thus, in terms of maintaining quality of life, VH after coronary revascularization needs further attention in these patients. (Circ J 2011; 75: 329-335)