Proliferative diabetic retinopathy (PDR) often leads to vision loss and needs vitrectomy surgery. Biomarkers like homocysteine (Hcy) and uric acid (UA) may affect recovery. A new study published in the World Journal of Diabetes checks their role in outcomes.
Study Setup and Groups
This prospective study at a tertiary center ran from June 2021 to December 2022. It enrolled 44 PDR patients and 46 non-diabetic controls, all getting pars plana vitrectomy (PPV). Teams measured serum and vitreous Hcy and UA levels. They tracked best-corrected visual acuity, retinal imaging, and capillary density before and after surgery.
Biomarker Levels in PDR Patients
PDR patients had much higher serum and vitreous Hcy and UA than controls. Serum Hcy and UA levels matched well with vitreous ones. This points to strong local buildup in the eye.
Hcy Ties to Early Vision Loss
High vitreous Hcy linked to poorer visual acuity at 1 day post-PPV. It also tied to thinner peripapillary retinal nerve fiber layer at 7 and 90 days. Foveal avascular zone grew larger at 90 days with high Hcy.
Retinal Microvascular Impacts
Vitreous Hcy correlated with lower inferior superficial capillary plexus width density at 7 days. Vitreous UA showed negative links at 30 days to nasal SCP length density and temporal/inner ring SCP width density. Serum levels showed no such ties.
Focus on Local Eye Markers
Vitreous Hcy, not serum, predicts post-PPV problems. This stresses the eye's local environment over body-wide factors in PDR care.