Evidence map›Paper›PMID 34624063›Full record

ArticlePloS one2021

Potential bias of preoperative intravitreal anti-VEGF injection for complications of proliferative diabetic retinopathy.

Kei Takayama, Hideaki Someya, Hiroshi Yokoyama, Takeshi Kimura, Yoshihiro Takamura, Masakazu Morioka, Hiroto Terasaki, Tetsuo Ueda, Nahoko Ogata, Shigehiko Kitano and 3 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 1 country.

Kei TakayamaDepartment of Ophthalmology, National Defense Medical College, Tokorozawa, Japan.ORCID 0000-0002-1477-9014
Hideaki SomeyaDepartment of Ophthalmology, National Defense Medical College, Tokorozawa, Japan.
Hiroshi YokoyamaDepartment of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan.
Takeshi KimuraDepartment of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan.
Yoshihiro TakamuraDepartment of Ophthalmology, University of Fukui Faculty of Medical Sciences, Yoshida, Japan.
Masakazu MoriokaDepartment of Ophthalmology, University of Fukui Faculty of Medical Sciences, Yoshida, Japan.
Hiroto TerasakiDepartment of Ophthalmology, Kagoshima University, Kagoshima, Japan.
Tetsuo UedaDepartment of Ophthalmology, Nara Medical University, Kashihara, Japan.
Nahoko OgataDepartment of Ophthalmology, Nara Medical University, Kashihara, Japan.
Shigehiko KitanoDiabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Maki TashiroDiabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Taiji SakamotoDepartment of Ophthalmology, Kagoshima University, Kagoshima, Japan.
Masaru TakeuchiDepartment of Ophthalmology, National Defense Medical College, Tokorozawa, Japan.
National Defense Medical College · JPHyogo Medical University · JPKagoshima University · JPNara Medical University · JPTokyo Women's Medical University · JPUniversity of Fukui · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIntravitreal anti-VEGF injection (IVI) is administered before vitrectomy to assist management of proliferative diabetic retinopathy (PDR)-related complications. In the clinical setting, retinal surgeons determine the use of preoperative IVI based on individual criteria. In this study, we investigated factors related to the potential bias of retinal surgeons in using IVI prior to vitrectomy for PDR-related complications, and evaluated the real-world outcomes of surgeon-determined preoperative IVI.

methodsMedical records of 409 eyes of 409 patients who underwent 25-gauge vitrectomy for PDR complications at seven Japanese centers (22 surgeons) were retrospectively reviewed. Ocular factors, demographic and general clinical factors, surgical procedures, and postoperative complications were compared between IVI group (patients who received preoperative IVI; 87 eyes, 21.3%) and non-IVI group (patients who did not receive preoperative IVI; 322 eyes, 78.7%). In addition, baseline HbA1c in IVI group and non-IVI group was compared between eyes with and without postoperative complications.

resultsAt baseline, IVI group was younger (P<0.001), had shorter duration of diabetes treatment (P = 0.045), and higher frequencies of neovascular glaucoma [NVG] (P<0.001) and tractional retinal detachment [TRD] (P<0.001) compared to non-IVI group. Although IVI group had higher frequencies of intraoperative retinal break and tamponade procedure, there were no significant differences in postoperative complications and additional treatments between two groups. Baseline HbA1c levels were also not correlated with postoperative complications of VH, NVG, and RD both in IVI group and non-IVI group. Logistic regression analysis identified age (P<0.001, odds ratio [OR] 0.95), presence of NVG (P<0.001, OR 20.2), and presence of TRD (P = 0.0014, OR 2.44) as preoperative factors in favor of IVI.

conclusionsIn this multicenter real-world clinical study, younger age and presence of NVG and TRD were identified as potential biases in using IVI before vitrectomy for PDR complications. Eyes that received preoperative IVI had more intraoperative retinal breaks requiring tamponade than eyes not receiving IVI, but postoperative outcome was not different between the two groups.

Indexed as

Diabetic RetinopathyIntravitreal InjectionsVascular Endothelial Growth Factor AVitrectomyAgedAngiogenesis InhibitorsBiasFemaleHumansMaleMiddle AgedPostoperative ComplicationsPreoperative CareRetrospective StudiesAngiogenesis InhibitorsVascular Endothelial Growth Factor A

Identifiers

PMID34624063
PMCPMC8500446
OpenAlexW3204531100

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.