Macular morphologic findings on optical coherence tomography after microincision vitrectomy for proliferative diabetic retinopathy

Abstract

Purpose: To investigate macular morphology on spectral-domain optical coherence tomography (SD-OCT) images after microincision vitrectomy for vitreous hemorrhage associated with proliferative diabetic retinopathy (PDR).

Methods: In this retrospective case series, 69 eyes (57 consecutive patients) that underwent 23-gauge microincision vitrectomy for vitreous hemorrhage due to PDR were investigated. Qualitative and quantitative characteristics on SD-OCT images [central retinal thickness, external limiting membrane (ELM), and the ellipsoid zone, epiretinal membranes involving the fovea, and hyperreflective foci at the fovea] were assessed 6 months postoperatively. Their association with the logarithm of the minimum angle of resolution visual acuity (logMAR VA) was evaluated.

Results: The ELM was disrupted in 15 and the ellipsoid zone in 27 eyes, and associated significantly (P < 0.001, for both comparisons) with poor visual outcomes 6 months postoperatively. Hyperreflective foci in the outer retinal layers were associated with either a disrupted ELM or ellipsoid zone and poor prognoses (P < 0.001, for all comparisons). The accumulation of hyperreflective foci at the fovea in five eyes was correlated significantly (P < 0.001) with poorer logMAR VA. Twenty-nine eyes had center-involved diabetic macular edema 6 months postoperatively, whereas the central thickness was not correlated with the logMAR VA (R = -0.148, P = 0.224). Eight eyes with either epiretinal membrane on SD-OCT images had greater central thickness (P = 0.003), although there were no differences in the logMAR VA between eyes with and without it (P = 0.648).

Conclusions: Foveal photoreceptor damage is associated with poor visual outcomes after microincision vitrectomy for vitreous hemorrhage due to PDR.