Case report: Treatment of vitreous hemorrhage in the presence of diabetic retinopathy

Abstract

Introduction Cardiovascular diseases are a major cause of incapacitation and mortality globally [1, 2]. Current statistics of diabetes mellitus is also a matter of concern. Diabetes mellitus (DM) is the third most prevalent disease after cardiovascular diseases and cancer. According to the WHO, the global number of patients with DM is around 285 million, and by 2025, it is expected to rise to 435 million [2]. In developed European countries, the estimated prevalence of DM in the general population varies from 3 to 10%, and in at risk and elderly patients it is as high as 30%. The prevalence of DM in Ukraine increases substantially year by year and the number of diabetic patients in the country exceeds one million. It is noteworthy that this number increases mainly due to those with type 2 DM. In patients diagnosed with DM before the age of 30 years, the incidence of diabetic retinopathy (DR) after 10 years is 50%, and after 30 years 90%. The incidence of DR in patients with type 1 DM is 42%, and in those with type 2 DM it exceeds 80%. DR rarely develops within 5 years of the onset of diabetes or before puberty [2]. About 5% of type 2 diabetics have DR at presentation. The pathogenesis of DR involves imbalanced carbohydrate metabolism and retinal microangiopathy [3, 4]. Diffuse retinal ischemia, increased anaerobic glycolysis, development of local acidosis and venous stasis result in deep hypoxia and initiation of proliferative processes [3-5]. Diabetic retinopathy is the main but not the only cause of visual impairment in patients with DM [4, 5]. Changes in ocular media [3] also degrade the quality of the image projected onto the retina. Thus, corneal epithelial dystrophy, transitory edema of lens fibers in hyperglycemia, diabetic cataract and vitreous hemorrhage can contribute to visual impairment in diabetic patients [3]. The purpose of the study was to report a case of unilateral vitreous hemorrhage developed in the presence of diabetic retinopathy.