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A. J. Dare, J. A. Cardillo, R. A. Costa, F. Tognin; Gas-Assisted Posterior Vitreous Detachment for the Treatment of Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5003.
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To report five cases of tractional diabetic macular edema that were successfully treated with a single intravitreous perfluoropropane (C3F8) gas bubble injection.
An interventional case series performed in a tertiary ophthalmic referral center enrolled a total of 5 diabetic patients with optical coherence tomography (OCT) confirmed vitreo-macular traction. In all cases, OCT showed a protruding fovea with partial vitreous detachment that remained attached to the fovea conferring to the macula a diffuse cystoid formation. All eyes were injected with 0.4 ml C3F8 gas using a 30 gauge needle via the pars plana and patients asked to maintain a head-prone posture up to two weeks. A serial post-injection OCT assessment were performed to assess traction relieve and central macular thickness (CMT).
OCT assessment disclosed a complete vitreofoveal separation, resolution of the macular edema and restoration of the normal foveal architecture were observed 4 weeks after treatment in all eyes eyes. A parallel favorable macular remodeling, reduced CMT and improved final visual acuity were sustained up to 6 months after the procedure. No secondary, procedure-related adverse effects were observed.
This relative simple procedure may assist a complete posterior vitreous detachment with relief of the hyaloid-foveolar traction, facilitating diabetic macular edema resolution.
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