Retinal Hyperreflective Foci on Optical Coherence Tomography before Vitrectomy for Diabetic Macular Edema and Postoperative Outcomes

Abstract

Purpose: : To assess the correlation between retinal hyperreflective foci detected by spectral-domain optical coherence tomography (SD-OCT) before vitrectomy for diabetic macular edema (DME) and visual outcomes after surgery.

Methods: : We retrospectively reviewed consecutive 76 eyes of 69 patients with DME who were treated with vitrectomy from October 2007 to September 2009. Thirty-two eyes of 28 patients without a thickened or taut posterior hyaloid membrane, who were scanned by SD-OCT before surgery and were followed up for at least 6 months after vitrectomy without any complications, were included in this study. The distribution of retinal hyperreflective foci on SD-OCT before surgery, the macular thickness, and best-corrected visual acuity (BCVA) during follow-up periods were studied.

Results: : The mean follow-up period was 15.3 ± 6.1 months. The final BCVA improved in 14 (44%), remained unchanged in 12 eyes (38%), and worsened in 6 eyes (19%). There were no significant differences in postoperative foveal thickness decrease and BCVA improvement between in the cases with rich intraretinal hyperreflective foci and in those with only a few. In the cases with subfoveal hyperreflective foci, improvement in BCVA was significantly limited, although the foveal thickness was significantly reduced after vitrectomy.

Conclusions: : Subfoveal hyperreflective foci detected by OCT preoperatively could be a negative factor for the result of vitrectomy against DME.

Keywords: diabetic retinopathy • imaging/image analysis: clinical • visual acuity