Abstract
Purpose:
To evacuate predictivity factor of OCT pattern in diabetic patient undergone to vitrectomy and peeling ILM.
Methods:
28 eyes, 18 men and 10 woman, aged between 52 e 65 years old, underwent surgery between january and july 2012. Participants were split into three groups: 1. sponge-like diffuse retinal thickening (10 eyes), 2. cystoid macular edema (8 eyes) and 3. diffuse retinal thickening with cysts (10 eyes). We performed in each patient BCVA the day before and one month after surgery, OCT ZEISS CIRRUS (Macular Cube 512x128) the day before and one month after surgery and vitrectomy 23G and peeling ILM after staining with indocyanine green. we evaluated the BCVA, the central macular thickness (CMT) and the maximum macular thickeness (MMT) in each group. The mean of BCVA logMAR was 0,48 in group1, 0,76 in group 2, 0, in group 3. The mean of the CMT was 455,3 micron in group 1, 527,12 micron in group 2, 550,9 micron in group 3. The mean of the MMT was 506,5 micron in group 1, 582,87 micron in group 2, 594,4 micron in group 3. Then we divided the patients into two groups: A) macular edema with savings the retinal outer layers (9 eyes) B) macular edema without saving the outer retinal layers (19 eyes). In group A , before surgery, the mean of the CMT was 404,67 micron; the mean of the MMT was 468 micron; the mean of BCVA was 0,55. In group B , before surgery, the mean of the CMT was 559,84 micron; the mean of the MMT was 604,42 micron; the mean of BCVA was 0,85
Results:
After one months the mean of BCVA was 0,37 in group1, 0,53 in group 2, 0,54 in group 3. The mean of the CMT was 281 micron in group 1, 297 micron in group 2, 296,5 micron in group 3. the mean of the MMT was 401,9 micron in group 1, 391 micron in group 2, 406,2 micron in group 3. In group A after surgery the mean of the CMT was 301,55 micron; the mean of the MMT was 372,89 micron; the mean of BCVA was 0,3.In group B after surgery the mean of the CMT was 286,16 micron; the mean of the MMT was 399,47 micron; the mean of BCVA was 0,59.
Conclusions:
There isn’t a correlation between morphological OCT edema pattern and anatomical results therefore the study suggests that the integrity of the outer retinal layers (ELM and photoreceptors) as well as a better pre-operative BCVA represent a positive prognostic factor for functional outcomes.