Macular ischemia and outcome of vitrectomy for diabetic macular edema.

Details

Serval ID
serval:BIB_1FA2BD6BD880
Type
Article: article from journal or magazin.
Collection
Publications
Title
Macular ischemia and outcome of vitrectomy for diabetic macular edema.
Journal
Japanese journal of ophthalmology
Author(s)
Kim J., Kang S.W., Shin D.H., Kim S.J., Cho G.E.
ISSN
1613-2246 (Electronic)
ISSN-L
0021-5155
Publication state
Published
Issued date
09/2015
Peer-reviewed
Oui
Volume
59
Number
5
Pages
295-304
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To investigate the effect of vitrectomy on the treatment of diabetic macular edema (DME) refractory to nonsurgical therapies and to determine the preoperative prognostic factors related to surgical outcomes.
Seventy-seven eyes from 74 patients who had undergone vitrectomy and macular photocoagulation 2 weeks after vitrectomy for nontractional DME refractory to anti-vascular endothelial growth factor or steroid injection and/or macular grid/focal photocoagulation were included. The eyes were divided into the responsive group (group 1) and the unresponsive group (group 2) according to the postoperative changes in central subfield thickness (CST). The changes in best-corrected visual acuity (BCVA) and CST were compared. Potential preoperative predictors including the size of the foveal avascular zone (FAZ) were assessed.
In group 1 (N = 51), the mean logarithm of the minimum angle of resolution BCVAs at baseline was 0.60 ± 0.30; 6 months after vitrectomy, 0.47 ± 0.28 (vs. baseline, p < 0.001); 12 months after vitrectomy, 0.38 ± 0.28 (vs. baseline, p < 0.001). However, in group 2 (N = 26), no significant change in BCVA was noted. Among the preoperative factors, only the size of the FAZ showed a significant difference between the two groups (0.45 ± 0.17 mm(2) in group 1 vs. 0.59 ± 0.26 mm(2) in group 2; p = 0.020). The enlarged FAZ was also significantly correlated with worse BCVA at the postoperative 6-month follow-up (r = 0.256, p = 0.025).
Vitrectomy is an effective treatment modality for DME refractory to nonsurgical therapies, especially in cases without enlarged FAZ. Preoperative evaluation of the perfusion status of the macula seems helpful to selecting candidates for vitrectomy.
Keywords
Aged, Diabetic Retinopathy/diagnosis, Diabetic Retinopathy/physiopathology, Diabetic Retinopathy/surgery, Female, Fluorescein Angiography, Follow-Up Studies, Humans, Ischemia/physiopathology, Laser Coagulation, Macula Lutea/blood supply, Macular Edema/diagnosis, Macular Edema/physiopathology, Macular Edema/surgery, Male, Middle Aged, Prognosis, Retina/pathology, Tomography, Optical Coherence, Visual Acuity/physiology, Vitrectomy, Diabetic macular edema, Foveal avascular zone, Macular ischemia, Pars plana vitrectomy
Pubmed
Web of science
Create date
10/03/2022 8:55
Last modification date
11/03/2022 6:33
Usage data