Skip to main content

Advertisement

SpringerLink
Log in

ILM peeling in nontractional diabetic macular edema: review and metanalysis

  • Review
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the effect of internal limiting membrane (ILM) peeling during vitrectomy for nontractional diabetic macular edema.

Methods

PUBMED, MEDLINE and CENTRAL were reviewed using the following terms (or combination of terms): diabetic macular edema, nontractional diabetic macular edema, internal limiting membrane peeling, vitrectomy, Müller cells. Randomized and nonrandomized studies were included. The eligible studies compared anatomical and functional outcomes of vitrectomy with or without ILM peeling for tractional and nontractional diabetic macular edema. Postoperative best-corrected visual acuity and central macular thickness were considered, respectively, the primary and secondary outcomes. Meta-analysis on mean differences between vitrectomy with and without ILM peeling was performed using inverse variance method in random effects.

Results

Four studies with 672 patients were eligible for analysis. No significant difference was found between postoperative best-corrected visual acuity or best-corrected visual acuity change of ILM peeling group compared with nonpeeling group. There was no significant difference in postoperative central macular thickness and central macular thickness reduction between the two groups.

Conclusions

The visual acuity outcomes in patients affected by nontractional diabetic macular edema using pars plana vitrectomy with ILM peeling versus no ILM peeling were not significantly different. A larger prospective and randomized study would be necessary.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Klein R, Klein BE, Moss SE, Cruickshanks KJ (1995) The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XV. The long term incidence of macular edema. Ophthalmology 102:7–16

    Article  CAS  Google Scholar 

  2. Semeraro F, Cancarini A, dell’Omo R, Rezzola S, Romano MR, Costagliola C (2015) Diabetic retinopathy: vascular and inflammatory disease. J Diabetes Res 2015:582060

    Article  CAS  Google Scholar 

  3. Stehphen J. Ryan. Non proliferative diabetic retinopathy, Chap 67. In: Retina, Vol II, 4th edn. pp 1275–1276

  4. Dell’Omo R, Semeraro F, Bamonte G, Cifariello F, Romano MR, Costagliola C (2013) Vitreous mediators in retinal hypoxic diseases. Mediators Inflamm 2013:935301

    PubMed  PubMed Central  Google Scholar 

  5. Agarwal D, Gelman R, Prospero Ponce C, Stevenson W, Christoforidis JB (2015) The vitreomacular interface in diabetic retinopathy. J Ophthalmol 2015:392983

    Article  Google Scholar 

  6. Bandello F, Lattanzio R, Zucchiatti I, Del Turco C (2013) Pathophysiology and treatment of diabetic retinopathy. Acta Diabetol 50:1–20

    Article  CAS  Google Scholar 

  7. Abari E, Kociok N, Hartmann U, Semkova I, Paulsson M, Lo A, Joussen AM (2013) Alterations in basement membrane immunoreactivity of the diabetic retina in three diabetic mouse models. Graefes Arch Clin Exp Ophthalmol 251:763–775

    Article  CAS  Google Scholar 

  8. Semeraro F, Parrinello G, Cancarini A et al (2011) Predicting the risk of diabetic retinopathy in type 2 diabetic patients. J Diabetes Complications 25:292–297

    Article  Google Scholar 

  9. Rinaldi M, Chiosi F, dell’Omo R et al (2012) Intravitreal pegaptanib sodium (Macugen®) for treatment of diabetic macular oedema: a morphologic and functional study. Br J Clin Pharmacol 74:940–946

    Article  CAS  Google Scholar 

  10. Bressler SB, Liu D, Glassman AR, Blodi BA, Castellarin AA, Jampol LM, Kaufman PL, Melia M, Singh H, Wells JA, Diabetic Retinopathy Clinical Research Network (2017) Change in diabetic retinopathy through 2 years: secondary analysis of a randomized clinical trial comparing aflibercept, bevacizumab, and ranibizumab. JAMA Ophthalmol 135(6):558–568

    Article  Google Scholar 

  11. Khan Z, Kuriakose RK, Khan M, Chin EK, Almeida DR (2017) Efficacy of the intravitreal sustained-release dexamethasone implant for diabetic macular edema refractory to anti-vascular endothelial growth factor therapy: meta-analysis and clinical implications. Ophthal Surg Lasers Imaging Retina 48(2):160–166

    Article  Google Scholar 

  12. Syed YY (2017) Fluocinolone acetonide intravitreal implant 0.19 (ILUVIEN(®)): a review in diabetic macular edema. Drugs 77(5):575–583

    Article  CAS  Google Scholar 

  13. Yamamoto T, Naoko A, Takeuchi S (2001) Vitrectomy for diabetic macular oedema: the role of posterior vitreous detachment and epimacular membrane. Am J Ophthalmol 132:369–377

    Article  CAS  Google Scholar 

  14. Diabetic retinopathy clinical research network writing committee, Haller JA, Qin H, Apte RS et al (2010) Vitrectomy outcomes in eyes with diabetic macular edema and vitreomacular traction. Opthtalmology 117:1087–1093

    Article  Google Scholar 

  15. Ikeda T, Sato K, Katano T, Hayashi Y (1999) Vitrectomy for cystoid macular oedema with attached posterior hyaloid membrane in patients with diabetes. Br J Opthtalmol 83:12–14

    Article  CAS  Google Scholar 

  16. Hartley KL, Smiddy WE, Flynn HW Jr, Murray TG (2008) Pars plana vitrectomy with internal limiting membrane peeling for diabetic macular edema. Retina 28:410–419

    Article  Google Scholar 

  17. Ternent L, Vale L, Boachie C, Burr JM, Lois N, Full-Thickness Macular Hole and Internal Limiting Membrane Peeling Study (FILMS) Group (2012) Cost-effectiveness of internal limiting membrane peeling versus no peeling for patients with an idiopathic full-thickness macular hole: results from a randomised controlled trial. Br J Ophthalmol 96:438–443

    Article  Google Scholar 

  18. Hasegawa T, Emi K, Ikeda T, Watanabe M, Takaoka G (2004) Long-term prognosis of internal limiting membrane peeling for idiopathic epiretinal membrane. Nihon Ganka Gakkai Zasshi 108:150–156

    PubMed  Google Scholar 

  19. Park DW, Dugel PU, Garda J et al (2003) Macular pucker removal with and without internal limiting membrane peeling: pilot study. Ophthalmology 110:62–64

    Article  Google Scholar 

  20. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50:1088–1101

    Article  CAS  Google Scholar 

  21. Bonnin S, Sandali O, Bonnel S, Monin C, el Sanharawi M (2015) Vitrectomy with internal limiting membrane peeling for tractional and non tractional diabetic macular edema: long-term results of a comparative study. Retina 35:921–928

    Article  Google Scholar 

  22. Ghassemi F, Bazvand F, Roohipoor R, Yaseri M, Hassanpoor N, Zarei M (2016) Outcomes of vitrectomy, membranectomy and internal limiting membrane peeling I patients with refractory diabetic macular edema and non-tractional epiretinal membrane. J Curr Ophthalmol 28:199–205

    Article  Google Scholar 

  23. Kumagai K, Furukawa M, Ogino N, Larson E, Iwaki M, Tachi N (2009) Long-term follow-up of vitrectomy for diffuse nontractional diabetic macular edema. Retina 29:464–472

    Article  Google Scholar 

  24. Kumagai K, Hangai M, Ogino N, Larson E (2015) Effect of internal limiting membrane peeling on long-term visual outcomes for diabetic macular edema. Retina 35:1422–1428

    Article  Google Scholar 

  25. Patel JI, Hykin PG, Schadt M et al (2006) Pars plana vitrectomy with and without peeling of the inner limiting membrane for diabetic macular edema. Retina 26:5–13

    Article  Google Scholar 

  26. Figueroa MS, Contreras I, Noval S (2008) Surgical and anatomical outcomes of pars plana vitrectomy for diffuse non tractional diabetic macular edema. Retina 28:420–426

    Article  Google Scholar 

  27. Gandorfer A, Messmer EM, Ulbig MW, Kampik A (2000) Resolution of diabetic macular edema after surgical removal of the posterior hyaloids and the inner limiting membrane. Retina 20:126–133

    Article  CAS  Google Scholar 

  28. Diabetic Retinopathy Clinical Research Network Writing Committee, Haller JA, Qin H, Apte RS et al (2010) Vitrectomy outcomes in eyes with diabetic macular edema and vitreomacular traction. Ophthalmology 117(1087–1093):e3

    Google Scholar 

  29. Kumagai K, Ogino N, Furukawa M et al (2002) Internal limiting membrane peeling in vitreous surgery for diabetic macular edema. Nihon Ganka Gakkai Zasshi 106:590–594

    PubMed  Google Scholar 

  30. Ikeda T, Sato K, Katano T, Hayashi Y (2000) Improved visual acuity following pars plana vitrectomy for diabetic cystoid macular edema and detached posterior hyaloid. Retina 20:220–222

    Article  CAS  Google Scholar 

  31. La Heij EC, Hendrikse F, Kessels AG, Derhaag PJ (2001) Vitrectomy results in diabetic macular oedema without evident vitreomacular traction. Graefes Arch Clin Exp Ophthalmol 239:264–270

    Article  Google Scholar 

  32. Yanyali A, Bozkurt KT, Macin A, Horozoglu F, Nohutcu AF (2011) Quantitative assessment of photoreceptor layer in eyes with resolved edema after pars plana vitrectomy with internal limiting membrane removal for diabetic macular edema. Ophthalmologica 226:57–63

    Article  Google Scholar 

  33. Bahadir M, Ertan A, Mertoğlu O (2005) Visual acuity comparison of vitrectomy with and without internal limiting membrane removal in the treatment of diabetic macular edema. Int Ophthalmol 26:3–8

    Article  Google Scholar 

  34. Yanyali A, Horozoglu F, Celik E, Nohutcu AF (2007) Long-term outcomes of pars plana vitrectomy with internal limiting membrane removal in diabetic macular edema. Retina 27:557–566

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Second University of Naples, Naples, Italy

    M. Rinaldi

  2. Department of Medicine and Health Sciences, University of Molise, Via Francesco De Sanctis 1, 86100, Campobasso, Italy

    R. dell’Omo, F. Chiosi & C. Costagliola

  3. Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Eye Clinic, University of Brescia, Brescia, Italy

    F. Morescalchi, F. Semeraro & E. Gambicorti

  4. Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy

    F. Cacciatore

  5. UOSD- Cardiac Transplantation and Mechanical Assistance, Monaldi Hospital, Naples, Italy

    F. Cacciatore

Authors
  1. M. Rinaldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. dell’Omo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Morescalchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. Semeraro
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E. Gambicorti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F. Cacciatore
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. F. Chiosi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. C. Costagliola
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. Chiosi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rinaldi, M., dell’Omo, R., Morescalchi, F. et al. ILM peeling in nontractional diabetic macular edema: review and metanalysis. Int Ophthalmol 38, 2709–2714 (2018). https://doi.org/10.1007/s10792-017-0761-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-017-0761-6

Keywords

Search

Navigation