Abstract
Purpose :
Background
Diabetic macula edema (DME) is a vision threatening disease. Quick resolution of edema is necessary in order to maintain visual acuity. While recent therapeutic strategies for DME have shifted to anti-VEGF therapy, vitrectomy remains an option when an epiretinal membrane (ERM) is present or there is vitreous opacity including hemorrhage.
Purpose
To clarify the efficacy of vitrectomy for DME, we retrospectively investigated surgical results and the factors which affected visual outcomes after surgery.
Methods :
Methods
Between 2008 to 2018, patients who underwent vitrectomy at the Kansai Medical University Hospital were investigated by clinical chart review. Best corrected visual acuity prior to surgery and at 1, 3, 6, and 12 months after surgery were evaluated. Central retinal thickness (CRT) was also evaluated at the same time points. Visual changes before and after vitrectomy were compared between patients with ERM (ERM(+)) and patients without ERM (ERM(-)). Visual improvement was assessed based on factors including age, presence of hard exudates, hypertension, hyperlipidemia, HbA1c, eGFR, and Hb.
Results :
Results
A total of 295 eyes from 201 cases were included in this study (114 males, 87 females, average age of 65.5 years). CRT was gradually reduced over time after surgery (p<0.01). BCVA was reduced immediately after surgery, but gradually improved. There were no statistically significant differences found except for the pre-surgery vs 12 months post-surgery comparisons (p=0.002). There were no statistically significant differences between the ERM(+) and ERM(-) group for either BCVA or CRT. There were no correlations between visual improvement and age, presence of hard exudates, hypertension, hyperlipidemia, HbA1c, eGFR, or Hb.
Conclusions :
Conclusions
Vitrectomy was shown to be an effective method for the treatment of DME. Although vitrectomy requires a longer post-surgical time to restore both vision and CRT compared to anti-VEGF therapy, it is able to achieve these improvements after only a single procedure.
This is a 2020 ARVO Annual Meeting abstract.