{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:40:06Z","timestamp":1787071206997,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J West Afr Coll Surg"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To investigate demographics, treatment methods, pre- and post-treatment vision of proliferative diabetic retinopathy (PDR) patients, and predictors of poor visual outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This is a multicentre chart review of consecutive PDR eyes, investigating vision, presence of vitreous haemorrhage (VH), tractional retinal detachment (TRD), diabetic macular edema (DME), and rubeosis. Rates of good vision (6\/60+) and poor vision (&lt; 6\/60) and rates of worse, same, or improved vision were the primary outcomes. The secondary outcome was the number of eyes in each treatment category.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 640 PDR eyes\/473 patients were evaluated [334 bilateral eyes (52.2%)\/167 patients (35.3%)]. Mean age: 58.9\/SD 10.97 years (17\u201395). Mean symptom duration: 12.8 months. Rates of DME, TRD, VH, TRD with VH, and rubeosis were 12%, 3%, 25.6%, 2.5%, and 15%, respectively. The five treatment categories include intravitreal antivascular endothelial growth factor injections (IVI) alone (392 eyes\/61.25%), IVI + retinal laser photocoagulation (86 eyes\/13.45%), IVI + cataract surgery (CS) (24 eyes\/3.76%), IVI + vitrectomy (V) (109 eyes\/17.0%), and IVI + CS + vitrectomy (29 eyes\/4.54%). IVI + CS had the highest mean number of intravitreal anti-VEGF use (2.96\/SD 4.56) and highest rate of improved vision (62.5%). IVI + vitrectomy had the highest worse vision (29%). IVI alone and IVI + CS had the highest pre- and post-treatment best corrected visual acuity (BCVA). TRD, rubeosis, VH, and no DME eyes had poor mean pretreatment BCVA (&lt; 6\/60). Post-treatment mean BCVA improved significantly in VH and DME. Poor pretreatment BCVA, TRD, TRD with VH, and rubeosis were predictors of poor outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>PDR is a cause of poor vision and associated poor treatment outcomes in Nigerians. Systematic, effective DR screening and retinal laser treatment of high-risk eyes is urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jwas.jwas_76_24","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T11:10:31Z","timestamp":1738667431000},"page":"335-343","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Proliferative Diabetic Retinopathy in Nigerians: Treatment Methods, Visual Outcomes, and Predictors of Poor Outcomes"],"prefix":"10.4103","volume":"15","author":[{"given":"Ogugua Ndubuisi","family":"Okonkwo","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Eye Foundation Hospital and Eye foundation Retina Institute, Lagos, Ogun State, Nigeria"},{"name":"Department of Ophthalmology, Eye Foundation Hospital, Abuja, Ogun State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adekunle Olubola","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye Foundation Hospital and Eye foundation Retina Institute, Lagos, Ogun State, Nigeria"},{"name":"Department of Ophthalmology, Eye Foundation Hospital, Abuja, Ogun State, Nigeria"},{"name":"Department of Ophthalmology, Eye Foundation Hospital, Ijebu-Ode, Ogun State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arinze Anthony","family":"Onwuegbuna","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Nnamdi Azikiwe University, Nnewi, Anambra State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayo Julius","family":"Bogunjoko","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye Foundation Hospital and Eye foundation Retina Institute, Lagos, Ogun State, Nigeria"},{"name":"Department of Ophthalmology, Eye Foundation Hospital, Ijebu-Ode, Ogun State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyin","family":"Akanbi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye Foundation Hospital, Abuja, Ogun State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayodele","family":"Akinye","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye Foundation Hospital, Ijebu-Ode, Ogun State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"CIT0001-20250613","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S0140-6736(23)01301-6","article-title":"Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: A systematic analysis for the Global Burden of Disease Study 2021","volume":"402","year":"2023","journal-title":"Lancet"},{"key":"CIT0002-20250613","doi-asserted-by":"crossref","first-page":"14790","DOI":"10.1038\/s41598-020-71908-9","article-title":"Global, regional, and national burden and trend of diabetes in 195 countries and territories: An analysis from 1990 to 2025","volume":"10","author":"Lin","year":"2020","journal-title":"Sci Rep"},{"key":"CIT0003-20250613","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1016\/S2214-109X(20)30489-7","article-title":"Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: The right to sight: An analysis for the Global Burden of Disease Study","volume":"9","year":"2021","journal-title":"Lancet Glob Health"},{"key":"CIT0004-20250613","doi-asserted-by":"crossref","first-page":"3362","DOI":"10.3390\/cells11213362","article-title":"Diabetic macular edema: Current understanding, molecular mechanisms and therapeutic implications","volume":"11","author":"Zhang","year":"2022","journal-title":"Cells"},{"key":"CIT0005-20250613","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1016\/S0161-6420(03)00475-5","article-title":"Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales","volume":"110","author":"Wilkinson","year":"2003","journal-title":"Ophthalmology"},{"key":"CIT0006-20250613","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.preteyeres.2015.08.001","article-title":"The progress in understanding and treatment of diabetic retinopathy","volume":"51","author":"Stitt","year":"2016","journal-title":"Prog Retin Eye Res"},{"key":"CIT0007-20250613","doi-asserted-by":"crossref","first-page":"525","DOI":"10.4103\/ijo.IJO_1591_20","article-title":"Neovascular glaucoma \u2013 A review","volume":"69","author":"Senthil","year":"2021","journal-title":"Indian J Ophthalmol"},{"key":"CIT0008-20250613","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1016\/j.ophtha.2021.03.010","article-title":"Racial, ethnic, and insurance-based disparities upon initiation of anti-vascular endothelial growth factor therapy for diabetic macular edema in the US","volume":"128","author":"Malhotra","year":"2021","journal-title":"Ophthalmology"},{"key":"CIT0009-20250613","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.ajo.2020.09.042","article-title":"The impact of race on short-term treatment response to bevacizumab in diabetic macular edema","volume":"222","author":"Osathanugrah","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"CIT0010-20250613","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1038\/eye.2017.95","article-title":"Black patients sustain vision loss while White and South Asian patients gain vision following delamination or segmentation surgery for tractional complications associated with proliferative diabetic retinopathy","volume":"31","author":"Mastropasqua","year":"2017","journal-title":"Eye (London)"},{"key":"CIT0011-20250613","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1001\/jamaophthalmol.2018.3255","article-title":"Diabetic retinopathy clinical research network. Five-year outcomes of panretinal photocoagulation vs intravitreous ranibizumab for proliferative diabetic retinopathy: A randomized clinical trial","volume":"136","author":"Gross","year":"2018","journal-title":"JAMA Ophthalmol"},{"key":"CIT0012-20250613","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1001\/jama.2015.15217","article-title":"Panretinal photocoagulation vs intravitreous ranibizumab for proliferative diabetic retinopathy: A randomized clinical trial","volume":"314","author":"Gross","year":"2015","journal-title":"JAMA"},{"key":"CIT0013-20250613","doi-asserted-by":"crossref","first-page":"2383","DOI":"10.1001\/jama.2020.23027","article-title":"Effect of intravitreous aflibercept vs vitrectomy with panretinal photocoagulation on visual acuity in patients with vitreous hemorrhage from proliferative diabetic retinopathy: A randomized clinical trial","volume":"324","author":"Antoszyk","year":"2020","journal-title":"JAMA"},{"key":"CIT0014-20250613","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1097\/00006982-200603000-00004","article-title":"Intravitreal bevacizumab (Avastin) treatment of proliferative diabetic retinopathy complicated by vitreous hemorrhage","volume":"26","author":"Spaide","year":"2006","journal-title":"Retina"},{"key":"CIT0015-20250613","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.ajo.2017.01.010","article-title":"Intravitreal bevacizumab for the treatment of vitreous hemorrhage due to proliferative diabetic retinopathy","volume":"176","author":"Parikh","year":"2017","journal-title":"Am J Ophthalmol"},{"key":"CIT0016-20250613","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1089\/jop.2012.0202","article-title":"Intravitreal bevacizumab (Avastin) and panretinal photocoagulation in the treatment of high-risk proliferative diabetic retinopathy","volume":"29","author":"Yang","year":"2013","journal-title":"J Ocul Pharmacol Ther"},{"key":"CIT0017-20250613","doi-asserted-by":"crossref","first-page":"e34856","DOI":"10.1097\/MD.0000000000034856","article-title":"Efficacy and safety of pan retinal photocoagulation combined with intravitreal anti-VEGF agents for high-risk proliferative diabetic retinopathy: A systematic review and meta-analysis","volume":"102","author":"Fu","year":"2023","journal-title":"Medicine (Baltim)"},{"key":"CIT0018-20250613","doi-asserted-by":"crossref","first-page":"e7512","DOI":"10.5867\/medwave.2019.01.7511","article-title":"Preoperative intravitreal bevacizumab for proliferative diabetic retinopathy patients undergoing vitrectomy \u2013 First update","volume":"19","author":"P\u00e9rez-Argando\u00f1a","year":"2019","journal-title":"Medwave"},{"key":"CIT0019-20250613","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/00004397-198402440-00004","article-title":"The diabetic retinopathy study and the early treatment diabetic retinopathy study","volume":"24","author":"Cantrill","year":"1984","journal-title":"Int Ophthalmol Clin"},{"key":"CIT0020-20250613","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1001\/archopht.1986.01050160038003","article-title":"Diabetic retinopathy vitrectomy study","volume":"104","author":"Charles","year":"1986","journal-title":"Arch Ophthalmol"},{"key":"CIT0021-20250613","doi-asserted-by":"crossref","first-page":"e0288805","DOI":"10.1371\/journal.pone.0288805","article-title":"Functional and structural outcomes and complications after pars plana vitrectomy for severe features of proliferative diabetic retinopathy in type 1 and type 2 diabetes mellitus","volume":"18","author":"Ka\u017amierczak","year":"2023","journal-title":"PLoS One"},{"key":"CIT0022-20250613","doi-asserted-by":"crossref","first-page":"58","DOI":"10.4103\/jwas.jwas_40_23","article-title":"Tractional retinal detachment: Prevalence and causes in Nigerians","volume":"13","author":"Nkanga","year":"2023","journal-title":"J West Afr Coll Surg"},{"key":"CIT0023-20250613","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/0002-9394(83)90330-6","article-title":"Vitrectomy for diabetic traction retinal detachment involving the macula","volume":"95","author":"Rice","year":"1983","journal-title":"Am J Ophthalmol"},{"key":"CIT0024-20250613","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1001\/archopht.1987.01060040067035","article-title":"Results and prognostic factors in vitrectomy for diabetic traction retinal detachment of the macula","volume":"105","author":"Thompson","year":"1987","journal-title":"Arch Ophthalmol"},{"key":"CIT0026-20250613","doi-asserted-by":"crossref","first-page":"e567","DOI":"10.1111\/j.1755-3768.2011.02184.x","article-title":"Panretinal photocoagulation (PRP) versus PRP plus intravitreal ranibizumab for high-risk proliferative diabetic retinopathy","volume":"89","author":"Filho","year":"2011","journal-title":"Acta Ophthalmol"},{"key":"CIT0027-20250613","doi-asserted-by":"crossref","first-page":"1144422","DOI":"10.3389\/fendo.2023.1144422","article-title":"Aflibercept for long-term treatment of diabetic macular edema and proliferative diabetic retinopathy: A meta-analysis","volume":"14","author":"Xie","year":"2023","journal-title":"Front Endocrinol (Lausanne)"}],"container-title":["Journal of West African College of Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jwas.jwas_76_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:43:05Z","timestamp":1787067785000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jwas.jwas_76_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,4]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jwas.jwas_76_24","relation":{},"ISSN":["2276-6944","2992-5827"],"issn-type":[{"value":"2276-6944","type":"print"},{"value":"2992-5827","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,4]]},"assertion":[{"value":"2024-05-19","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-04","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}