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Importance Five‐year survival rates in patients undergoing vitrectomy for diabetic retinopathy (DR) vary from 68% to 95%. No study has been conducted in an Australian population. Background: We aimed to determine the survival rates of patients undergoing diabetic vitrectomy in an Australian population. Design Retrospective audit, tertiary centre hospitals and private practices. Participants: All individuals in South Australia and the Northern Territory who underwent their first vitrectomy for diabetic complications between January 1, 2007 and December 31, 2011. Methods: An audit of all eligible participants has been completed previously. Survival status as of July 6, 2018 and cause of death were obtained using SA/NT DataLink. Kaplan‐Meier survival curves and multivariate cox‐regressions were used to analyse survival rates and identify risk factors for mortality. Main outcome measures: Five‐, seven‐ and nine‐year survival rates. Results: The 5‐, 7‐ and 9‐year survival rates were 84.4%, 77.9% and 74.7%, respectively. The most common cause of death was cardiovascular disease. Associated with increased mortality independent of age were Indigenous ethnicity (HR = 2.04, 95% confidence interval [CI]: 1.17‐3.57, P = 0.012), chronic renal failure (HR = 1.76, 95% CI: 1.07‐2.89, P = 0.026) and renal failure requiring dialysis (HR = 2.32, 95% CI: 1.25‐4.32, P = 0.008). Conclusions and relevance: Long‐term survival rates after diabetic vitrectomy in Australia are similar to rates reported in other populations. Indigenous ethnicity and chronic renal failure were the most significant factors associated with long‐term mortality. This information can guide allocation of future resources to improve the prognosis of these high risk groups. [ABSTRACT FROM AUTHOR]

Importance: Diabetes mellitus (DM) is highly prevalent among Indigenous Australians and contributes greatly to premature death. The association of diabetic retinopathy (DR) with early mortality, however, has not previously been reported among Indigenous Australians., Background: To investigate associations between 10-y mortality and the presence of DR among Indigenous Australians living in Central Australia., Design: Prospective cohort study., Participants: A total of 1257 individuals aged 40 y or older, living in one of 30 remote communities within Central Australia were recruited through outreach clinics., Methods: Fundus examination was performed on all patients at recruitment. The presence of any DR was recorded., Main Outcome Measures: Mortality rate and cause were obtained at 10 y, and their association with any DR was determined., Results: Ten-year all-cause mortality was found to be 29.3%. Of those with DM but no DR, 24.0% died during the 10 y after recruitment, compared with 40.1% for those with any DR (P < 0.0001). Those who had any DR were 75% more likely to die (hazard ratio [HR] 1.75; P < 0.0001) and were more likely to die from renal failure (HR 2.71; P = 0.004) or stroke (HR 5.91; P = 0.026)., Conclusion and Relevance: The presence of any DR among those with DM, was associated with a 75% greater 10-y all-cause mortality rate and were more likely to die from renal failure or stroke. We recommend that whenever DR is noted among Indigenous Australians with DM, that they be immediately referred for investigation and management of risk factors, which might predispose to renal failure and stroke., (© 2018 Royal Australian and New Zealand College of Ophthalmologists.)

Importance: Visual outcomes following diabetic vitrectomy have not previously been studied in an Australian population., Background: This analysis aimed to determine the rate of, and factors associated with visual success following diabetic vitrectomy performed for Indigenous and non-Indigenous Australians, and investigate factors predisposing to early progression to diabetic retinopathy (DR) requiring vitrectomy., Design: Retrospective, population-based audit., Participants: All patients undergoing vitrectomy for the complications of DR in South Australia (SA) and the Northern Territory (NT) between 2007 and 2011., Methods: Medical records were audited and data collected, including demographics, diabetic history, past treatment for DR, indication for vitrectomy and visual acuity pre and postoperatively., Main Outcome Measures: Visual success (gain of ≥15 ETDRS letters) at 6 and 12 months, postoperatively., Results: A total of 495 diabetic vitrectomies, for 404 eyes of 335 patients were performed in SA and NT between 2007 and 2011. 77 (23%) patients requiring diabetic vitrectomy were Indigenous Australians. 87% of patients undergoing diabetic vitrectomy had stable or improved vision at 1 year, postoperatively. There was no significant difference between indigenous and non-indigenous eyes achieving visual success (P = 0.929). Timely preoperative laser treatment (P = 0.03) and preoperative visual acuity (P = 0.01) were the predominant factors associated with visual success., Conclusions and Relevance: Indigenous patients are just as likely to have improved vision following diabetic vitrectomy as non-Indigenous Australians. However, the small subset of indigenous patients with blind eyes prior to vitrectomy are significantly less likely to improve from surgery. The underlying factors associated with poor outcomes in this group requires further exploration., (© 2017 Royal Australian and New Zealand College of Ophthalmologists.)