One of the common complications of proliferative diabetic retinopathy (PDR) is vitreous haemorrhage (VH). Despite adequate panretinal photocoagulation (PRP) treatment, up to 18% of patients experience new or recurrent VH, which can compromise visual acuity to varying degrees [1]. Traditionally, vitrectomy (PPV) is done only in patients with severe visual impairment due to dense VH based on the findings of the Diabetic Retinopathy Vitrectomy Study (DRVS). While the DRVS reported visual benefits in the early PPV group, it also found an increased risk of visual loss due to postoperative complications (40%) [2]. However, PPV has become a much safer procedure with significantly lower complication rates due to recent advances in surgical techniques and equipment [3]. This raises the question of whether early PPV could be a viable alternative to the traditional management approach, particularly for patients with good initial visual acuity. To date, there is no evidence on the safety and outcomes of this approach in this sub-group of patients.

The aim of this study is to compare the clinical outcomes and safety profile of early PPV versus delayed PPV in patients with their first episode of VH due to PDR with a best-corrected visual acuity (BCVA) of ≥60 ETDRS letters or Snellen ≥6/18. This is a retrospective, comparative, observational study designed to compare the clinical outcomes of early PPV, defined as PPV performed at ≤6 weeks, versus delayed PPV, defined as PPV > 6 weeks, in patients with a first episode of VH due to PDR. The research was conducted at Moorfields Eye Hospital in accordance with the Declaration of Helsinki and was registered with the Clinical Effectiveness Department (N°1502).