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Surgical outcomes of vitrectomy for intractable diabetic macular edema

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To investigate clinical outcomes of vitrectomy for intractable diabetic macular edema (DME) in which anti-vascular endothelial growth factor (anti-VEGF) agents or periocular steroid were not effective.

Methods

This retrospective study examined 27 eyes of 25 cases. The main measurements included changes in visual acuity (VA) and retinal morphology. Vitrectomies were performed using the Constellation System 25G.

Results

Prior to undergoing vitrectomy, patients were treated with anti-VEGF agents or periocular injection of triamcinolone acetonide. The average number of anti-VEGF agent injections was 3.1 ± 2.8. Triamcinolone was used in 15 eyes. There was no significant change in the mean logMAR best-corrected visual acuity (BCVA) between baseline and posttreatment, with values of 0.49 ± 0.29 and 0.55 ± 0.33, respectively (P = 0.31). Compared with preoperative BCVA, postoperative BCVA improved by more than two lines in 4 eyes (14%), remained the same in 17 eyes (63%), and decreased in 6 eyes (23%). Morphologically, retinal thickness improved by more than 50 μm in 16 eyes (59%), remained unchanged in 7 eyes (26%), and increased in 5 eyes (18%). Retinal edema resolved in all of the cases in which macular epiretinal membrane (ERM) or vitreomacular traction (VMT) was detected by optical coherence tomography during pretreatment.

Conclusions

Vitrectomy can potentially stabilize the retinal morphology in intractable DME and is likely more effective in DME cases accompanied by ERM or VMT.

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analyses were performed by Ryo Mukai. The first draft of the manuscript was written by Ryo Mukai, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-35-15 Showa-cho, Maebashi, Gunma, 371-8511, Japan

    Ryo Mukai, Hidetaka Matsumoto & Hideo Akiyama

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  1. Ryo Mukai
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  2. Hidetaka Matsumoto
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  3. Hideo Akiyama
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Correspondence to Ryo Mukai.

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All authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent to review their medical records was obtained from all individual participants included in this study.

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Mukai, R., Matsumoto, H. & Akiyama, H. Surgical outcomes of vitrectomy for intractable diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 259, 363–368 (2021). https://doi.org/10.1007/s00417-020-04898-z

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  • DOI: https://doi.org/10.1007/s00417-020-04898-z

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