Establishment and validation of a prognostic nomogram for long-term low vision after diabetic vitrectomy

Frontiers in Endocrinology

Endocrinology

Xiang Zhang¹  Bojie Hu¹  Wenbo Li¹  Siqiong Bai¹  Haoxin Guo¹  Zetong Nie¹  Naxin Duan¹  Xiaorong Li¹  Zhaoxiong Wang²  Kuan Wang³ 

[1]Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China

[2]Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China

[3]Department of Ophthalmology, Tianjin Baodi Hospital, Tianjin, China

[4]Baodi Clinical College, Tianjin Medical University, Tianjin, China

[5]Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China

[6]Department of Retinal Disease, Cangzhou Eye Hospital, Cangzhou, China

关键词: proliferative diabetic retinopathy;    vitrectomy;    nomogram;    risk prediction model;    low vision;   

DOI  :  10.3389/fendo.2023.1196335

 received in 2023-03-29, accepted in 2023-08-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

PurposeWe aimed to evaluate the risk factors and develop a prognostic nomogram of long-term low vision after diabetic vitrectomy.MethodsThis retrospective study included 186 patients (250 eyes) that underwent primary vitrectomy for proliferative diabetic retinopathy with a minimum follow-up period of one year. Patients were assigned to the training cohort (200 eyes) or validation cohort (50 eyes) at a 4:1 ratio randomly. Based on a cutoff value of 0.3 in best-corrected visual acuity (BCVA) measurement, the training cohort was separated into groups with or without low vision. Univariate and multivariate logistic regression analyses were performed on preoperative systemic and ocular characteristics to develop a risk prediction model and nomogram. The calibration curve and the area under the receiver operating characteristic curves (AUC) were used to evaluate the calibration and discrimination of the model. The nomogram was internally validated using the bootstrapping method, and it was further verified in an external cohort.ResultsFour independent risk factors were selected by stepwise forward regression, including tractional retinal detachment (β=1.443, OR=4.235, P<0.001), symptom duration ≥6 months (β=0.954, OR=2.595, P=0.004), preoperative BCVA measurement (β=0.540, OR=1.716, P=0.033), and hypertension (β=0.645, OR=1.905, P=0.044). AUC values of 0.764 (95% CI: 0.699-0.829) in the training cohort and 0.755 (95% CI: 0.619-0.891) in the validation cohort indicated the good predictive ability of the model.ConclusionThe prognostic nomogram established in this study is useful for predicting long-term low vision after diabetic vitrectomy.

【 授权许可】

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Copyright © 2023 Guo, Wang, Nie, Zhang, Wang, Duan, Bai, Li, Li and Hu