Abstract
Purpose :
Pars plana vitrectomy (PPV) with membrane peeling remains the gold standard procedure for the treatment of symptomatic epiretinal membranes (ERMs). This study sought to examine the potential impact of type 2 diabetes (T2DM) with mild ocular involvement on visual and anatomic outcomes after surgery for idiopathic ERMs.
Methods :
The study comprised a retrospective, cross-sectional analysis of patients consecutively treated for an idiopathic ERM by means of PPV with ERM peeling without removal of the internal limiting membrane (ILM). Visual and anatomic outcomes at one- and six-month postoperatively were compared between patients with and without T2DM. All patients with T2DM had either mild non-proliferative diabetic retinopathy (NPDR) or no ocular involvement. Visual acuity (VA) was assessed as Snellen best corrected visual acuity (VA) and central macular thickness (CMT) determined by optical coherence tomography (OCT). No participant included in the study had any systemic, surgical, or ocular adverse events reported.
Results :
Thirty-one eyes (29 patients) were included. Thirty-one percent of patients had T2DM (mean hemoglobin A1c 6.5%). Preoperative VA and CMT were similar between control eyes and those with T2DM. At 1-month, VA did not significantly improve for control eyes (LogMAR 0.468 ± 0.176 to LogMAR 0.368 ± 0.238, P=0.120) or those eyes with T2DM (LogMAR 0.489 ± 0.145 to LogMAR 0.350 ± 0.233, P=0.905). By 6 months, VA improved only for control eyes (LogMAR 0.468 ± 0.176 to LogMAR 0.209 ± 0.148, P=0.001) but not for those eyes with T2DM (LogMAR 0.489 ± 0.145 to LogMAR 0.356 ± 0.391, P=0.352). By contrast, 6-month CMT improved for both control eyes (465 ± 74 µm to 382 ± 40 µm, P=0.001) and T2DM eyes (419 ± 114 µm to 365 ± 111 µm, P=0.001) and was similar between the groups (382 ± 40 μm vs 365 ± 111 μm, P=0.521).
Conclusions :
While PPV with membrane peeling effectively restored retinal anatomy, patients with T2DM may exhibit suboptimal visual outcomes compared to their non-diabetic counterparts, despite achieving similar short-term anatomic improvement.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.