scholarly journals Efficacy and safety of 5-fluorouracil in infrared monitor guided bleb revision

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rumi Kawashima ◽  
Kenji Matsushita ◽  
Ryo Kawasaki ◽  
Kohji Nishida
Keyword(s):  
Proportional Hazards ◽  
Anterior Segment ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Subconjunctival Injection ◽  
Success Rates ◽  
Additional Surgery ◽  
Group A ◽  
Group B

Abstract Purpose Infrared monitor-guided bleb revision (IRGBR), an alternative needling system, visualizes anterior-segment tissues around the bleb not visible during needle revision after trabeculectomy. This study determined the safety and efficiency of 5-fluorouracil (5-FU) as an adjunctive anti-metabolite in IRGBR. Methods We retrospectively analyzed 43 consecutive eyes (40 patients; 14 eyes, primary open-angle; 29 eyes, secondary glaucoma) treated with IRGBR for failing filtering blebs. The patients were divided into two groups. The first one had IRGBR without adjunctive 5-FU subconjunctival injection, and the second one had IRGBR with 5-FU. We performed Kaplan-Meier survival analysis using log-rank tests after 2 years of follow-up and Cox proportional hazards regression model to analyze the dependence of the survival time on predictor variables. Two failure criteria were defined as the need for additional surgery for intraocular pressure (IOP) reduction and the IOP at two consecutive follow-up visits based on definition 1, IOP ≧22 mmHg and definition 2, IOP ≧17 mmHg. Results Thirty eyes (29 cases) underwent IRGBR with subconjunctival 5-FU injection (group A in the second term) and 13 eyes (11 cases) without 5-FU (group B in the first term). The success rates 24 months after IRGBR were 73.3 and 23.1%, respectively, in groups A and B based on the definition 1 failure and 56.7 and 7.7% based on the definition 2 failure. Complications included transient bleb leaks (group A, 3 eyes; group B, none) and choroidal detachment (group A, 1 eye; group B, none). No use of 5-FU and IOPs ≧10 mmHg 1 week after IRGBR were significant risk factors. Conclusions Adjunctive 5-FU in IRGBR achieved a better success rate for failing trabeculectomy blebs.

scholarly journals Impact of megatherapy on survival after relapse from stage 4 neuroblastoma in patients over 1 year of age at diagnosis: a report from the European Group for Bone Marrow Transplantation.

1993 ◽  
Vol 11 (12) ◽  
pp. 2330-2341 ◽  
Author(s):  
R Ladenstein ◽  
C Lasset ◽  
O Hartmann ◽  
D Frappaz ◽  
A Garaventa ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Proportional Hazards ◽  
Bone Marrow Involvement ◽  
Marrow Transplant ◽  
Cox Proportional Hazards ◽  
Age At Diagnosis ◽  
Conventional Dose ◽  
Stage 4 ◽  
Group A ◽  
Group B

PURPOSE Relapse from stage 4 neuroblastoma usually carries a poor prognosis. A retrospective study using the European Bone Marrow Transplant (EBMT) Solid Tumor Registry was undertaken to define the role of megatherapy (MGT) in relapsed patients. PATIENTS AND METHODS After relapse, 33 boys and 15 girls with previous stage 4 neuroblastoma received intensification by MGT followed by either autologous (n = 42) or allogeneic (n = 6) bone marrow rescue in 11 European institutions. The median age at diagnosis was 47 months (range, 14 to 134) and the median interval from diagnosis to relapse was 16 months (range, 4 to 94). Thirty patients had received only conventional-dose primary treatments (group A), whereas 18 patients had previously received intensification with MGT (group B). The median follow-up time of the total group is 95 months (range, 25 to 185). RESULTS The actuarial overall survival rate at 2 years after MGT for relapse is 27% for group A and 0% for group B (P = .02). Three adverse, independent prognostic factors were confirmed by multivariate analysis using the Cox proportional hazards regression model: an interval of less than 12 months between diagnosis and relapse (P < .0001), nonresponding or untreated relapse (P = .0002), and previous MGT during primary treatments (P = .055). None of the other variables analyzed, such as sex, age, bone or bone marrow involvement at diagnosis or at relapse, and type of MGT at relapse, influenced outcome in this patient cohort. CONCLUSION Responding patients who relapse more than 12 months from diagnosis who had not received previous MGT appear to benefit from consolidation MGT. Relapse patients who do not fulfill these criteria gain no advantage from this cost-intensive procedure and should be treated differently.

scholarly journals DORSAL WRIST GANGLION

2016 ◽  
Vol 23 (03) ◽  
pp. 246-250
Author(s):  
Yousaf Jan ◽  
Waqas Ahmad ◽  
Shaukat Hussain ◽  
Muhammad Shah ◽  
Ahmad Din
Keyword(s):  
Surgical Excision ◽  
Success Rates ◽  
Research Committee ◽  
Patients With Cancer ◽  
Group A ◽  
One Year ◽  
Group B ◽  
Study Setting ◽  
Dorsal Wrist Ganglion

Objectives: To evaluate and compare the effect of aspiration plus methylprednisone injection versus surgical excision of the dorsal wrist ganglions in terms of resolution,complications and recurrence. Study Design: Prospective study. Setting: Surgical wardHayatabad Medical Complex, Peshawar. Period: June 2009 to December 2011. Methodology:After taking permission from ethical and research committee. Included patients were all adult ofboth gender with dorsal wrist ganglion. Patients with cancer, bleeding disorders and diabeteswere excluded from the study. The patients were divided in two groups: Group A includedpatients for aspiration and injection treatment, while Group B included patients underwentsurgical excision. All the patients were followed for complete resolution of ganglion, anycomplications of treatment and recurrence within one year. Follow up arranged at 7th day, 1,3, 6 and 12 months. Results: Total of 80 patients was included in the study. Out of 80, 65%(n=52) were females while 35% (n=28) were males. The mean age was 26.37±5.62 years.Group A and group B patients had overall success rates of 75% and 95%, with recurrence of25% and 5% in group A and group B respectively. In methylprednisolone group, mild pain wasreported by 70% (n=28), while in the surgical excision group, all the patients experienced mildto moderate pain postoperatively which necessitated oral analgesics for few days. Conclusion:Surgical excision is superior to injection-aspiration method for dorsal wrist ganglion treatmentbecause of high success and low recurrence rate. As injection-aspiration treatment

scholarly journals Risk of Blindness Among Patients With Diabetes and Newly Diagnosed Diabetic Retinopathy

2021 ◽  
Author(s):  
Charles C. Wykoff ◽  
Rahul N. Khurana ◽  
Quan Dong Nguyen ◽  
Scott P. Kelly ◽  
Flora Lum ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Newly Diagnosed ◽  
Increased Risk ◽  
Good Vision

<b>OBJECTIVE</b> <p>To evaluate association between initial diabetic retinopathy (DR) severity/risk of blindness in patients with newly diagnosed DR/good vision in the U.S.</p> <p><b>RESEARCH DESIGN AND METHODS</b></p> <p>Retrospective cohort study of adult patients with good vision (20/40 or better)/newly diagnosed DR between 1 January 2013 and 31 December 2017 (index date) in the American Academy of Ophthalmology’s IRIS<sup>®</sup> Registry. Primary exposure of interest, DR severity at index: mild nonproliferative DR (NPDR), moderate NPDR, severe NPDR, proliferative DR (PDR). Main outcome measure: development of sustained blindness (SB), defined as study eyes with Snellen visual acuity readings of 20/200 or worse at two separate visits ≥3 months apart that did not improve beyond 20/100.</p> <p><b>RESULTS</b></p> <p>Among 53,535 eligible eyes (mean follow-up, 662.5 days), 678 (1.3%) eyes developed SB. Eyes with PDR at index represented 10.5% (5,629/53,535) of the analysis population but made up 26.5% (180/678) of eyes that developed SB. Kaplan-Meier analysis revealed that eyes with moderate NPDR, severe NPDR, and PDR at index were 2.6, 3.6, and 4.0 times more likely, respectively, to develop SB after 2 years of DR diagnosis versus eyes with mild DR at index. In a Cox proportional hazards model adjusted for index characteristics/development of ocular conditions during follow-up, eyes with PDR had an increased risk of developing SB versus eyes with mild NPDR at index (hazard ratio, 2.26; 95% CI, 2.09−2.45).</p> <p><b>CONCLUSIONS</b></p> In this longitudinal ophthalmologic registry population involving eyes with good vision, more advanced DR at first diagnosis was a significant risk factor for developing SB.

The Efficacy of Ab Externo Canaloplasty by Using a Nonabsorbable Suture and No Viscoelastics; IOP Results, Intraoperative and Early Complication Rates within 6-Month Follow-Up Period

2021 ◽  
Author(s):  
Iraklis Vastardis ◽  
Sofia Fili ◽  
Georgios Perdikakis ◽  
Kalliopi Kontopoulou ◽  
Zisis Gatzioufas ◽  
...  
Keyword(s):  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Complication Rates ◽  
Success Rates ◽  
Intraoperative Complication ◽  
Nonabsorbable Suture ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background To report the efficacy of ab externo canaloplasty by exclusively using only a nonabsorbable suture as a standalone operation or combined with phacoemulsification in terms of mean intraocular pressure (IOP), medication reduction, and intra- and postoperative complication rates as well as additional glaucoma surgery. Patients and Methods Forty-eight patients with primary open-angle glaucoma (POAG) and 50 eyes were divided into two groups according to the operation performed (Group A canaloplasty, n = 34 and Group B canaloplasty combined with phaco, n = 16), respectively. The success criteria were evaluated between three IOP ranges: a) IOP ≤ 16 mmHg, b) ≤ 18 mmHg, and c) ≤ 21 mmHg. Complete success was considered the percentage of eyes reaching these goals with no medication and qualified success with or without medication. Groups A and B were compared with the Kaplan-Meier test. Mean IOP and medication reduction as well as additional glaucoma surgery were also evaluated. The follow-up time was 6 months. Statistical importance was given at p < 0.05. Results Fail rate and intraoperative conversion of canaloplasty to other surgery (trabeculotomy due to extensive cheese-wiring) accounted for 12% (6 eyes), while a mandatory usage of the iTrack 250A microcatheter to successfully overcome intracanalicular bridging of the Schlemmʼs canal accounted for 20% (10 eyes). The most common early postoperative complications in both groups were hyphema, cheese wiring, and transient IOP rising. The mean IOP in Group A reduced from 23.67 ± 6.06 mmHg to 13.35 ± 4.23 mmHg and in Group B, it reduced from 23.55 ± 6.19 mmHg to 12.75 ± 1.5 mmHg at 6 months (p < 0.001). Group Aʼs absolute success rates accounted for a) 44%, b) 47.1%, and c) 52.9% in comparison to Group B [a) 50%, b) 50%, and c) 56.3%] at 6 months (p < 0.05). Qualified success with or without medication showed no statistical differences between the groups. The mean medication reduction was significantly lower (p < 0.001) in both groups (Group A from baseline 3.2 ± 1.23 to 0.95 ± 1.35 and Group B from 3.12 ± 0.88 to 1.12 ± 0.75 at 6 months, respectively). Five eyes (10%) required additional glaucoma surgery. Conclusions Ab externo canaloplasty by exclusively using only a nonabsorbable suture as a standalone operation or combined with phacoemulsification seems to lower the mean IOP and medication sufficiently. However, they pose a greater surgical challenge and intraoperative complication rate. Additional glaucoma surgery or medication following both procedures may be necessary to achieve an optimal target IOP.

scholarly journals Parity and the risk of incident dementia: a COSMIC study

2020 ◽  
Vol 29 ◽  
Author(s):  
J. B. Bae ◽  
D. M. Lipnicki ◽  
J. W. Han ◽  
P. S. Sachdev ◽  
T. H. Kim ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Alzheimer Dementia ◽  
Grand Multiparity ◽  
Incident Dementia

Abstract Aims To investigate the association between parity and the risk of incident dementia in women. Methods We pooled baseline and follow-up data for community-dwelling women aged 60 or older from six population-based, prospective cohort studies from four European and two Asian countries. We investigated the association between parity and incident dementia using Cox proportional hazards regression models adjusted for age, educational level, hypertension, diabetes mellitus and cohort, with additional analysis by dementia subtype (Alzheimer dementia (AD) and non-Alzheimer dementia (NAD)). Results Of 9756 women dementia-free at baseline, 7010 completed one or more follow-up assessments. The mean follow-up duration was 5.4 ± 3.1 years and dementia developed in 550 participants. The number of parities was associated with the risk of incident dementia (hazard ratio (HR) = 1.07, 95% confidence interval (CI) = 1.02–1.13). Grand multiparity (five or more parities) increased the risk of dementia by 30% compared to 1–4 parities (HR = 1.30, 95% CI = 1.02–1.67). The risk of NAD increased by 12% for every parity (HR = 1.12, 95% CI = 1.02–1.23) and by 60% for grand multiparity (HR = 1.60, 95% CI = 1.00–2.55), but the risk of AD was not significantly associated with parity. Conclusions Grand multiparity is a significant risk factor for dementia in women. This may have particularly important implications for women in low and middle-income countries where the fertility rate and prevalence of grand multiparity are high.

scholarly journals History of stroke is a major factor to affect prognosis of elderly chronic limb-threatening ischemia patients with frailty after endovascular therapy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Kanda ◽  
Y Ikeda ◽  
T Sonoda ◽  
K Anzaki ◽  
R Arikawa ◽  
...  
Keyword(s):  
Endovascular Therapy ◽  
Proportional Hazards ◽  
Univariate Analysis ◽  
Geriatric Medicine ◽  
Cox Proportional Hazards ◽  
Medicine Research ◽  
History Of ◽  
Group A ◽  
Hs Crp ◽  
Group B

Abstract Background Chronic limb-threatening ischemia (CLTI) is the most advanced form of severe arteriosclerosis, and CLTI patients are known to have poor prognosis due to complication of polyvascular diseases, including cerebrovascular disease. Stroke often causes disability of exercise, leading to develop frailty and sarcopenia, and frailty and sarcopenia are known to important factors affecting the prognosis of cardiovascular disease. However, the effect of history of stroke for clinical outcomes in elderly CLTI patients with frailty has not been well evaluated. Purpose The aim of the present study was to investigate whether a history of stroke affects prognosis of elderly CLTI patients with frailty after endovascular therapy (EVT). Methods The subject was 228 consecutive elderly (≥65 year) CLTI patients underwent EVT. These patients had frailty with clinical frailty scale 5 or 6 or 7 which was defined by Geriatric Medicine Research. Clinical frailty was assessed on admission before procedure of EVT by physicians or other health professionals. The study patients were divided into two groups based on patients with or without history of stroke group (Group A and B). We investigated the association between history of stroke on admission and outcome after EVT. Results All-cause death ≤6 month and ≤12 month after EVT were 10 cases (4%) and 19 cases (8%). Group A had higher rate of all-cause death ≤6month and ≤12 month (14 vs. 3%, p=0.012, 19 vs. 6%, p=0.019) than those of Group B. Kaplan Meier analysis elucidated that survival rate was significantly lower in Group A compared to that in Group B (p=0.031). As a result of cox proportional hazards analysis, all-cause death ≤6 month was associated with history of stroke [hazard ratio (HR): 5.07, 95% confidence interval (CI): 1.47–17.52, p=0.010)], hs-CRP (HR: 1.09, 95% CI: 1.01–1.16, p=0.010) in the univariate analysis. Similarly, cox proportional hazards analysis for revealed that history of stroke (HR: 3.02, 95% CI: 1.19–7.68, p=0.020), hs-CRP (HR: 1.09, 95% CI: 1.03–1.14, p&lt;0.001), hemodialysis (HR: 2.53, 95% CI: 1.03–6.24, p=0.043), use of clopidogrel (HR: 0.22, 95% CI: 0.07–0.78, p=0.019) and serum albumin level (HR: 0.40, 95% CI: 0.21–0.80, p=0.008) were significantly associated with all-cause death ≤12 month. Multivariate analysis models after adjusted for the demographic characteristics of patients and clinically relevant factors for all-cause death ≤6 month and ≤12 month after EVT revealed that history of stroke was an independent risk factor (HR: 5.18, 95% CI: 1.44–17.43, p=0.011, HR: 2.98, 95% CI: 1.71–7.61, p=0.022). Conclusions These data suggested that history of stroke was a crucial independent predictor for incidence of all-cause death in elderly CLTI patients with frailty. Funding Acknowledgement Type of funding source: None

scholarly journals Surgical outcomes in acute dacryocystitis patients undergoing endonasal endoscopic dacryocystorhinostomy with or without silicone tube intubation

2021 ◽  
Vol 14 (6) ◽  
pp. 844-848
Author(s):  
Bo Yu ◽  
◽  
Jia-Ying Sun ◽  
Qian Ye ◽  
Yun-Hai Tu ◽  
...  
Keyword(s):  
Granulation Tissue ◽  
Tissue Formation ◽  
Success Rates ◽  
Granulation Tissue Formation ◽  
Treatment Groups ◽  
Group A ◽  
Silicone Intubation ◽  
Silicone Tube Intubation ◽  
Group B

AIM: To establish the necessity of silicone tube intubation in acute dacryocystitis (AD) patients undergoing endonasal endoscopic dacryocystorhinostomy (En-DCR). METHODS: Patients presenting with unilateral AD were randomly assigned to two treatment groups. En-DCR procedures were performed following lacrimal abscess formation, with the operation being performed with silicone intubation for patients in group B but not group A. Functional success was defined by an absence of additional AD episodes, no epiphora, and ostium patency as established via endoscopic evaluation or fluorescein irrigation. Operative success rates and demographic variables were compared between treatment groups. RESULTS: In total, 66 patients were analyzed in the present study (33 per group), with complete postoperative data having been successfully collected from 27 and 22 patients in group A and group B, respectively. All patients exhibited complete resolution of acute inflammation. Upon follow-up, granulation tissue was detected around the ostium at higher rates in group B (9/22, 40.9%) relative to group A (4/27, 14.8%). At the 12-month follow-up time point, patients in group A exhibited higher success rates (25/27, 92.6%) relative to patients in group B (20/22, 90.9%), but this difference was not significant. Cases of lacrimal passage reconstruction failure in both groups were attributed to excessive fibrous and/or granulation tissue formation proximal to the intranasal ostium. CONCLUSION: Given that these two operative approaches are associated with similar rates of operative success and in light of differences in granulation tissue formation, cost, and operative duration, these data do not support the routine silicone intubation of AD patients following En-DCR surgery.

Post-thrombotic syndrome in patients treated with rivaroxaban or enoxaparin/vitamin K antagonists for acute deep-vein thrombosis

2016 ◽  
Vol 116 (10) ◽  
pp. 733-738 ◽  
Author(s):  
Saskia Middeldorp ◽  
Martin H. Prins ◽  
Akos F. Pap ◽  
Anthonie W. A. Lensing ◽  
Arina J. ten Cate-Hoek ◽  
...  
Keyword(s):  
Vitamin K ◽  
Proportional Hazards ◽  
Vitamin K Antagonists ◽  
Randomised Trial ◽  
Significant Risk ◽  
Treatment Compliance ◽  
Cox Proportional Hazards ◽  
Compression Stocking ◽  
Post Thrombotic Syndrome

SummaryPost-thrombotic syndrome (PTS) is a common complication of deepvein thrombosis (DVT). Poor quality treatment with vitamin K antagonists (VKA) is a risk factor for PTS. We hypothesised that treatment with the direct oral anticoagulant (DOAC) rivaroxaban may lower PTS incidence as compared to enoxaparin/VKA, as DOACs have a more stable pharmacologic profile than VKA. We performed a post-hoc subgroup analysis of the Einstein DVT trial (n=3449). Kaplan-Meier survival analysis was performed to compare the cumulative incidence of PTS between the rivaroxaban and enoxaparin/VKA groups. Hazard ratios (HR) and 95 % confidence intervals (CI) were calculated using Cox proportional hazards models. We included 336 patients with a mean age of 58 ± 16 years and a median follow-up after index DVT of 57 months (interquartile range 48–64). Of these, 162 (48 %) had been treated with rivaroxaban and 174 (52 %) with enoxaparin/VKA. The cumulative PTS incidence at 60 months follow-up was 29 % in the rivaroxaban group and 40 % in the enoxaparin/VKA group. After adjusting for age, gender, body mass index, previous VTE, ipsilateral recurrent DVT, extent of DVT, idiopathic DVT, duration of anticoagulant treatment, compliance to assigned study medication, elastic compression stocking use and active malignancy, the HR of PTS development for rivaroxaban was 0.76 (95 % CI: 0.51–1.13). In conclusion, treatment of acute DVT with rivaroxaban was associated with a numerically lower but statistically non-significant risk of PTS compared to enoxaparin/VKA treatment. The potential effect on reducing PTS deserves evaluation in a large randomised trial.Supplementary Material to this article is available online at www.thrombosis-online.com.

Trabeculectomy with OloGen versus Mitomycin C for the Treatment of Silicone Oil-Induced Glaucoma

2021 ◽  
Author(s):  
Hisham Samy Shalaby ◽  
Noureldin Hussein Hashem
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Silicone Oil ◽  
Success Rates ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Pressure Lowering ◽  
Group A ◽  
Group B

Abstract Aim To compare the intraocular pressure-lowering effect and success rate of trabeculectomy with OloGen to that of trabeculectomy with mitomycin C (MMC) in cases of silicone oil-induced glaucoma. Materials and Methods Forty eyes of forty patients with elevated intraocular pressure (IOP) after vitrectomy and silicone oil injection (followed by silicone oil removal) were assigned to two groups. Group A included 20 cases who underwent trabeculectomy with OloGen, while group B cases contained 20 cases undergoing trabeculectomy with MMC. The follow-up period was 24 months. Patients enrolled had IOP > 21 mmHg despite being on antiglaucoma medications. Results The mean postoperative IOP reduction was lower in group A than in group B at all follow-up visits, but this difference was not statistically significant (p > 0.05). Moreover, group A and B patients were found to be similar as regards the need for postoperative antiglaucoma medications on all follow-up visits. The Kaplan-Meier survival analysis curves for the two groups revealed slightly higher success rates in group B than in group A. However, these differences were not statistically significant for both qualified success (IOP ≤ 21 mmHg with or without antiglaucoma medications) and complete success (IOP ≤ 21 mmHg without antiglaucoma medications). There was no significant difference in the postoperative complication rate between the two groups. Conclusion OloGen implant lowers IOP to a similar extent as MMC when combined with trabeculectomy for the treatment of silicone oil-induced glaucoma, and with comparable success rates. The rate of postoperative complications is similar for OloGen implantation and MMC.

scholarly journals Risk of Blindness Among Patients With Diabetes and Newly Diagnosed Diabetic Retinopathy

2021 ◽  
Author(s):  
Charles C. Wykoff ◽  
Rahul N. Khurana ◽  
Quan Dong Nguyen ◽  
Scott P. Kelly ◽  
Flora Lum ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Newly Diagnosed ◽  
Increased Risk ◽  
Good Vision

<b>OBJECTIVE</b> <p>To evaluate association between initial diabetic retinopathy (DR) severity/risk of blindness in patients with newly diagnosed DR/good vision in the U.S.</p> <p><b>RESEARCH DESIGN AND METHODS</b></p> <p>Retrospective cohort study of adult patients with good vision (20/40 or better)/newly diagnosed DR between 1 January 2013 and 31 December 2017 (index date) in the American Academy of Ophthalmology’s IRIS<sup>®</sup> Registry. Primary exposure of interest, DR severity at index: mild nonproliferative DR (NPDR), moderate NPDR, severe NPDR, proliferative DR (PDR). Main outcome measure: development of sustained blindness (SB), defined as study eyes with Snellen visual acuity readings of 20/200 or worse at two separate visits ≥3 months apart that did not improve beyond 20/100.</p> <p><b>RESULTS</b></p> <p>Among 53,535 eligible eyes (mean follow-up, 662.5 days), 678 (1.3%) eyes developed SB. Eyes with PDR at index represented 10.5% (5,629/53,535) of the analysis population but made up 26.5% (180/678) of eyes that developed SB. Kaplan-Meier analysis revealed that eyes with moderate NPDR, severe NPDR, and PDR at index were 2.6, 3.6, and 4.0 times more likely, respectively, to develop SB after 2 years of DR diagnosis versus eyes with mild DR at index. In a Cox proportional hazards model adjusted for index characteristics/development of ocular conditions during follow-up, eyes with PDR had an increased risk of developing SB versus eyes with mild NPDR at index (hazard ratio, 2.26; 95% CI, 2.09−2.45).</p> <p><b>CONCLUSIONS</b></p> In this longitudinal ophthalmologic registry population involving eyes with good vision, more advanced DR at first diagnosis was a significant risk factor for developing SB.

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