Quantitative Assessment of Photoreceptor Layer in Eyes with Resolved Edema after Pars Plana Vitrectomy with Internal Limiting Membrane Removal for Diabetic Macular Edema

Background: Diabetes mellitus remains the leading cause of blindness among working age Americans with diabetic macular edema being the most common cause for moderate and severe vision loss. Objective: To investigate the anatomical and visual benefits of pars plana vitrectomy with inner limiting membrane peeling in patients with nontractional diabetic macular edema as well as correlation of integrity of outer retinal layers on spectral domain optical coherence tomography to visual outcomes. Methods: We retrospectively reviewed the charts of 42 diabetic patients that underwent vitrectomy with internal limiting membrane peeling for nontractional diabetic macula edema. The integrity of outer retinal layers was evaluated and preoperative central macular thickness and visual acuity were compared with data at 1 month, 3 months and 6 months postoperatively. The student t-test was used to compare the groups. Results: 31 eyes were included. While no differences were seen at 1 and 3 months, there was significant improvement of both central macular thickness and visual acuity at the 6 months follow up visit compared to preoperatively (357, 427 microns; p=0.03. 20/49, 20/82; p=0.03) . Patients with intact external limiting membrane and ellipsoid zone had better preoperative vision than patients with outer retinal layer irregularities (20/54, 20/100; p=0.03) and greater visual gains postoperatively (20/33, p<0.001 versus 20/81; p=non-significant). Conclusion: Pars plana vitrectomy with internal limiting membrane peeling can improve retinal anatomy and visual acuity in patients with nontractional diabetic macular edema. Spectral domain optical coherence tomography may help identify patients with potential for visual improvement.

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Pars plana vitrectomy with removal of the internal limiting membrane in the treatment of persistent diabetic macular edema

American Journal of Ophthalmology ◽

10.1016/j.ajo.2004.09.076 ◽

2005 ◽

Vol 139 (3) ◽

pp. 447-454 ◽

Cited By ~ 67

Author(s):

Franco M. Recchia ◽

Alan J. Ruby ◽

Cynthia A. Carvalho Recchia

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Pars Plana Vitrectomy ◽

Internal Limiting Membrane ◽

Pars Plana ◽

Persistent Diabetic Macular Edema

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Pars Plana Vitrectomy and Removal of the Internal Limiting Membrane in Diabetic Macular Edema Unresponsive to Grid Laser Photocoagulation

European Journal of Ophthalmology ◽

10.1177/112067210601600412 ◽

2006 ◽

Vol 16 (4) ◽

pp. 573-581 ◽

Cited By ~ 26

Author(s):

A Yanyali ◽

F. Horozoglu ◽

E. Celik ◽

Y. Ercalik ◽

A.F. Nohutcu

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Pars Plana Vitrectomy ◽

Laser Photocoagulation ◽

Internal Limiting Membrane ◽

Pars Plana

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Evaluation of Macular Changes in Long Term Period Following Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Diabetic Macular Edema

Ophthalmologica ◽

10.1159/000514992 ◽

2021 ◽

Author(s):

Betul Onal Gunay ◽

Gurkan Erdogan

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Pars Plana Vitrectomy ◽

Internal Limiting Membrane ◽

Additional Treatment ◽

Final Visit ◽

Ilm Peeling ◽

Pars Plana

Aim: To evaluate long term macular changes following pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for diabetic macular edema (DME) Methods: Forty eligible eyes of 37 patients were included in this retrospective study. Best corrected visual acuity (BCVA), central macular thickness (CMT) and 5-mm macular volume (5-MV) were examined preoperatively and at postoperative 1st, 2nd, 3rd, 6th, 12th, 24th months and final visits. Response to surgical treatment was considered as recurrence, reincrease and recovery of DME based on macular changes. Results: Mean follow-up time was 51.1±19.0 months following surgery. Recurrence (n=5) and reincrease (n=17) of DME was observed in 22 eyes (55%) and additional treatments were applied. Recovery of DME was observed in 18 eyes (45%). Preoperative and final visit mean BCVAs (logMAR) were 1.08±0.37 and 0.93±0.45, respectively (p=0.02). Preoperative and final visit mean CMTs were 514.74±155.65 µm and 281.87±112.58 µm, respectively (p<0.001). The 5-MV significantly decreased following surgery (8.18±1.57 mm3 to 6.52±1.39 mm3) (p<0.001). DME was present in 12 eyes (%30) at final visit. Conclusion: Although PPV with ILM peeling had an efficacy in DME management, this effect tends to decrease over time such that considerable amount of patients required additional treatment.

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