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Purpose: To investigate the effects of vitrectomy as a treatment for the proliferative diabetic retinopathy (PDR) in patients under 40 years old., Methods: Sixty eyes of 37 patients under 40 years old with PDR who had undergone vitrectomy for the first time in Juntendo University Urayasu Hospital were included in this study. Preoperative condition, operation methods, visual acuity after operation and complications both during or after operation, especially neovascular glaucoma (NVG), were reviewed retrospectively., Results: Visual acuity improved in 43 eyes (72%) by more than 0.2 logMAR compared to that before the operation, remained stable in 4 eyes (6%) and deteriorated in 13 eyes (22%) by more than 0.2 logMAR compared to that before operation. Optic atrophy and phthisis caused by NVG constituted 69% of the causes of complicated final visual acuity. Male patients and patients who had both hypertension and proteinuria had significantly higher prevalence of NVG after vitrectomy (p < 0.05), and patients who retained their lens after the first vitrectomy had a significantly lower prevalence of NVG after the operation (p < 0.05)., Conclusions: In young PDR patients under 40 years old, postoperative NVG was the main reason for severe visual impairment. Multifactorial causes, both general and ophthalmic seem to be implicated in the onset and progression of NVG derived from PDR.

A 53-year-old man visited his family doctor complaining of chest pain and cough in January 2006. He had a 5-year history of uncontrolled diabetes mellitus. His illness was diagnosed as pneumonia of the left lingular division. Antibiotics were started but his pneumonia worsened repeatedly after insufficient antibiotics due to his poor compliance with medication. In addition to pneumonia, he began to have hemoptysis at the end of May and was admitted to our hospital. Contrast-enhanced CT scan on admission showed a lung abscess on the left lingular division and formation of a pulmonary pseudoaneurysm inside the abscess. Treatment with SBT/ABPC rapidly improved his condition but massive hemoptysis recurred 9 days after admission. Embolization of the bronchial artery and pulmonary pseudoaneurysm successfully controlled airway bleeding. When hemoptysis occurs due to sustained inflammation such as a lung abscess, bleeding from the pulmonary artery should be considered and a precise evaluation including contrast-enhanced CT and pulmonary angiography made.