Vitrectomy Outcomes in Eyes with Tractional Diabetic Macular Edema

Ophthalmic Res. 2019;61(2):94-99. doi: 10.1159/000489459. Epub 2018 Nov 23.

Abstract

Purpose: To evaluate pars plana vitrectomy (PPV) outcomes in cases with tractional diabetic macular edema (tDME).

Methods: We conducted a single-center retrospective study with a follow-up of 12 months. Forty-six eyes with tDME of 38 patients submitted to PPV between 2013 and 2015 were assessed. A standard PPV was performed and surgical outcomes were registered at the 3-, 6-, and 12-month follow-up.

Results: The baseline median best corrected visual acuity (BCVA) in ETDRS (Early Treatment Diabetic Retinopathy Study) letters and the median central foveal thickness (CFT) were 43.0 letters and 491.0 µm, respectively. At the 12-month follow-up, a median decrease in CFT of 232.7 µm was observed. A CFT < 300 µm was achieved in 65.2% of the cases (52.2% needing no further treatment); a BCVA improvement by ≥10 letters was achieved in 60.0%, but there was a decrease of ≥10 letters in 13.0% of the cases. DME recurrence was observed in 10.9% of the cases, with a median time of development after vitrectomy of 6 months. As a major postoperative complication, a macular hole was observed in 1 patient (2.1%).

Conclusions: In our series, PPV for tDME induced an improvement in retinal thickening and visual outcome in more than 50% of the cases, with low recurrence rates and a low number of postoperative complications.

Keywords: Best corrected visual acuity; Central foveal thickness; Epiretinal membrane; Internal limiting membrane; Tractional diabetic macular edema; Vitrectomy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Diabetic Retinopathy / physiopathology
  • Diabetic Retinopathy / surgery*
  • Female
  • Humans
  • Macular Edema / physiopathology
  • Macular Edema / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retina / pathology
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy*