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S. Maguluri, C. Recchia, A. Leon, F.M. Recchia; OCT Analysis of the Vitreomacular Interface in Diabetic Patients Without Maculopathy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):380.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: It has been postulated that changes in the vitreomacular interface contribute to the development of clinically significant macular edema (CSME) in diabetic patients, and that vitrectomy may be of therapeutic benefit in these cases. Optical coherence tomography (OCT) demonstration of focal vitreomacular traction is often used to determine therapy. However, there exist few normative data regarding the vitreomacular interface in patients without diabetic maculopathy. The present study was undertaken to analyze the characteristics of the vitreomacular interface by OCT in diabetic patients without maculopathy. Methods: Consecutive patients seen between 11–03 and 10–04 with diabetes mellitus (DM) and no clinical evidence of maculopathy were prospectively enrolled. Demographics, duration and type of diabetes, severity of retinopathy, and OCT findings were recorded. The following OCT findings of vitreomacular anatomy were analyzed: epiretinal membrane (ERM), retinal thickening, foveal contour, complete vitreous attachment, focal vitreous attachment limited to the central 3 mm, focal vitreous attachment limited to the central 1 mm. Results: 100 eyes of 50 diabetic patients (54% female, mean age = 53.5 yrs, 86% Type II DM) were included. Duration of diabetes ranged from 1 month to 45 years (mean = 8.1 yrs, median = 5.0 yrs). 26% of eyes had mild nonproliferative diabetic retinopathy (NPDR) and 84% had no diabetic retinopathy. No eyes showed OCT evidence of ERM, retinal thickening, or loss of foveal contour. Complete vitreous attachment was observed in 91% of eyes. In the remaining 9% of eyes, vitreous attachment was present only in the central 3 mm. Conclusions: Focal vitreomacular traction was not seen in the majority of diabetic patients without maculopathy. It is possible that identifiable patterns of vitreomacular traction may accompany the development of macular edema. Ongoing prospective evaluation of this cohort of patients, as well as comparison with patients with diabetic maculopathy, will help to elucidate the contribution of the vitreomacular interface to CSME and the utility of OCT findings.
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