Published online Apr 15, 2024. doi: 10.4239/wjd.v15.i4.654
Peer-review started: December 5, 2023
First decision: December 21, 2023
Revised: December 30, 2023
Accepted: February 6, 2024
Article in press: February 6, 2024
Published online: April 15, 2024
Processing time: 128 Days and 18.1 Hours
Neovascular glaucoma (NVG) is likely to occur after pars plana vitrectomy (PPV) for diabetic retinopathy (DR) in some patients, thus reducing the expected benefit. Understanding the risk factors for NVG occurrence and building effective risk prediction models are currently required for clinical research.
To develop a visual risk profile model to explore factors influencing DR after surgery.
We retrospectively selected 151 patients with DR undergoing PPV. The patients were divided into the NVG (NVG occurrence) and No-NVG (No NVG occur
After importing the data into a logistic regression model, we concluded that a posterior capsular defect, preoperative vascular endothelial growth factor ≥ 302.90 pg/mL, glycosylated hemoglobin ≥ 9.05%, aqueous fluid interleukin 6 (IL-6) ≥ 53.27 pg/mL, and aqueous fluid IL-10 ≥ 9.11 pg/mL were independent risk factors for postoperative NVG in patients with DR (P < 0.05). A nomogram model was established based on the aforementioned independent risk factors, and a computer simulation repeated sampling method was used to internally and externally verify the nomogram model. The area under the curve (AUC), sensitivity, and specificity of the model were 0.962 [95% confidence interval (95%CI): 0.932-0.991], 91.5%, and 82.3%, respectively. The AUC, sensitivity, and specificity of the external validation were 0.878 (95%CI: 0.746-0.982), 66.7%, and 95.7%, respectively.
A nomogram constructed based on the risk factors for postoperative NVG in patients with DR has a high prediction accuracy. This study can help formulate relevant preventive and treatment measures.
Core Tip: The primary treatment for diabetic retinopathy (DR) is pars plana vitrectomy (PPV); however, neovascular glaucoma (NVG) is likely to occur after surgery. This affects the prognosis of surgery. Risk factors for NVG after PPV have been studied; however, whether inflammatory factors in the aqueous humor are related to the risk of NVG formation is unknown. We explored the risk factors (including inflammatory factors) for NVG and built a histogram model based on these factors, which confirmed the effectiveness and applicability of this model in assessing NVG after PPV in patients with DR.