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DME was detected by the SD-OCT to be associated with sole extrafoveal vitreous traction in one-third of the patients. Further studies are required to evaluate the clinical consequences of these observations.

PURPOSE. To present the vitreoretinal interface in diabetic macular edema (DME) associated with both epiretinal membrane (ERM) and incomplete posterior vitreous detachment (PVD), as detected by spectral-domain optical coherence tomography (SD-OCT). METHODS. In a retrospective study, findings were analyzed in one eye in consecutive patients. Excluded were eyes that had undergone vitreoretinal intervention or that had complete PVD or complete vitreous attachment. RESULTS. Of 44 eyes with DME and ERM, incomplete PVD was apparent in 23 (52.2%) eyes. A hyperreflective unified ERM/posterior vitreous cortex (PViC) membrane, or EVi membrane, was apparent in various sizes in 20 (87.0%) of the 23 eyes. This unified membrane (n = 20) was associated with vitreopapillary adherence in 19 (82.6%) of 23 eyes. Two major OCT presentations (n = 23) were encountered: incomplete vitreopapillary detachment (n = 11; 25% of 44), with attachment to the macular ERM, and posterior vitreous detachment from the macula, associated with vitreopapillary adhesion (n = 10; 22.7%), in four different manifestations. In the remaining two eyes, there was no association between the ERM and the PViC. CONCLUSIONS. In eyes with DME, ERM, and incomplete PVD, the posterior cortical vitreous and ERM appeared as one united EVi membrane in various lengths in most eyes, typically associated with vitreopapillary adhesion. These findings may have clinical importance in the context of epimacular membrane characteristics and its removal in DME.

This pilot study suggests that when early recurrence of pterygium is already evident, 5-FU treatment into the dome of the fibrovascular tissue may be beneficial in halting its progression, by rendering it atrophic. A prospective, randomized, controlled study is required to confirm the efficacy of this approach.

Purpose To describe an association between optic disc traction and diabetic macular oedema (DME) unresponsive to laser treatment. Methods A retrospective review of all patients with DME who attended our clinic between September 2001 and November 2003 was undertaken. The patients had undergone ophthalmic history and examination, fluorescein angiography, and optical coherence tomography (OCT) of the macular area and optic nerve head (ONH). A total of 10 nonvitrectomized eyes that were found to have an elevation of the ONH secondary to vitreopapillary traction were included in the analysis. Eyes with additional traction at the posterior pole were excluded. Results Out of the 10 eyes (seven patients, aged 47-79 years) with vitreo-papillary traction, nine had previously undergone argon laser photocoagulation(s) for DME. In seven eyes (seven patients), OCT verified the vitreopapillary traction as the sole traction, whereas in the fellow eyes of three patients vitreomacular traction was evident as well. In the seven eyes with only vitreopapillary traction, OCT demonstrated parapapillary serous retinal detachment in two eyes and a diffuse DME in all eyes (mean foveal thickness, 3967144 lm). Maximal thickness of the papillo-macular bundle site was adjoining the elevated ONH in three eyes, and was maximal at the central macula in the other four eyes. Ultrasonography (n ¼ 5) revealed an incomplete detachment of the posterior hyaloid in each, adherent only at the ONH. Conclusions Diffuse DME unresponsive to laser treatment may be associated with vitreopapillary traction. Further studies should indicate whether these two phenomena could suggest a cause and effect in such eyes.