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Kwang-Soo Kim, Rebecca Kim, Yu Cheol Kim; Spectral-domain optical coherence tomographic findings of tractional macular elevation in eyes with proliferative diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):197. doi: https://doi.org/.
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To analyze the findings of spectral-domain optical coherence tomography (SD-OCT) of macular traction associated with proliferative diabetic retinopathy.
A retrospective review of 20 patients (20 eyes) who had undergone pars plana vitrectomy for tractional retinal detachment in proliferative diabetic retinopathy was perfprmed to evaluate SD-OCT findings of macula. Group 1 contains eyes without tractional retinal detachment (TRD) in posterior pole with SD-OCT and group 2 includes eyes with TRD in posterior pole with SD-OCT. We compared clinical characteristics and visual outcomes in each groups. In addition, we classified according to retinal component in SD-OCT, compared the clinical characteristics and surgical outcome in each groups.
Of 20 eyes, group 1 had 12 eyes and group 2 had 8 eyes. There are no statistically differences in age, best corrected visual acuity (BCVA) before and after the operation and mean spherical equivalent. Group 2 had longer axial length than group 1 (p=0029). In Group 1, 9 eyes (75%) had improved the BCVA after vitrectomy and 4 eyes (42%) had final visual acuity more than 0.4. Group 2 had only 4 eyes (40%) with improving BCVA after vitrectomy and 2 eyes (25%) with final BCVA more than 0.4. Regardless of group, SD-OCT represents component of sponge, bridging columnar, saw tooth, cystoid macular edema and retinoschisis. The eyes with cyst component have poor visual outcome. Of 9 eyes have performed SD-OCT after vitrectomy, there are remained sponge component in 8 eyes, saw tooth component in 7 eyes, and cyst component in 3 eyes. These components decreased as time passed after vitrectomy. There are no remained bridging columnar component.
Each group has BCVA improvement with vitrectomy and removal of tractional membrane and release the tractional force. However, the eyes with TRD has poor surgical outcome compared with the eyes without TRD. SD-OCT is useful tool for presenting the change of retina like sponge, bridging columnar, saw tooth, cystoid macular edema and retinoschisis components from tractional elevation, and it helps understanding of tractional elevation in proliferative diabetic retinopathy.
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