The effectiveness of vitrectomy for diffuse diabetic macular edema may depend on its preoperative optical coherence tomography pattern

Abstract

Background: To investigate the effectiveness of vitrectomy for diffuse diabetic macular edema (DDME) and its dependence on optical coherence tomography (OCT) findings.

Methods: The records of 65 patients and 81 eyes who received vitrectomy for DDME and followed up for at least 6 months were retrospectively reviewed. All eyes were classified according to their morphological characteristics on OCT including sponge-like diffuse retinal thickening (SDRT: n = 13), cystoid macular edema (CME: n = 42), serous retinal detachment (SRD: n = 13), and the combination of all morphological characteristics (FULL: n = 13). The best-corrected visual acuity (BCVA) and spectral domain OCT were investigated preoperatively and at 1, 3, and 6 months postoperatively.

Results: At six months after surgery, BCVA in logMAR units was significantly improved in all groups except the SDRT group. The improvement was -0.04 ± 0.20 in the SDRT group (P = 0.504), -0.16 ± 0.24 in the CME group (P < 0.01), -0.32 ± 0.32 in the SRD group (P < 0.01), and -0.26 ± 0.19 in the FULL group (P < 0.01), and significantly better in eyes with subretinal fluid (SRF; the SRD and FULL groups) than in eyes without SRF (the SDRT and CME groups, P = 0.003).

Conclusions: Vitrectomy can be a useful treatment option for DDME, particularly for eyes with SRF.

Keywords: Classification; Diabetic macular edema; Optical coherence tomography; Pattern; Subretinal fluid; Vitrectomy.