Abstract
Purpose: :
To evaluate the efficacy of intravitreal gas injection to induce a posterior vitreous detachment (PVD) and reduce clinically significant diabetic macular oedema.
Methods: :
Pars plana injection of 0.3 ml of 100% C3F8 gas was performed in 5 eyes of 5 patients with diabetic macular oedema that had failed to respond to at least 4 episodes of laser therapy. All patients had Type 2 diabetes, with a mean age of 64 (range 61–83). Evaluation was performed with visual acuity measurement, biomicroscopy, fluorescein angiography and OCT. Post–treatment review was performed at 1, 4 and 12 weeks and 4 monthly thereafter.
Results: :
Over a mean review of 18 months (range 9–36), a PVD was induced in all eyes, with signs of reduction in macular thickness and resolution of exudates. Mean visual improvement was 11 ETDRS letters (range 4–21). Apart from a transient vitreous haemorrhage in one eye, there were no significant treatment–related complications.
Conclusions: :
PVD–induced pneumatic retinopexy appears to have a beneficial effect on refractory diabetic macular oedema. The mechanisms may relate to relief of vitreoretinal traction and improved oxyenation in the macular region.
Keywords: diabetic retinopathy • macula/fovea