Influence of retinal internal limiting membrane peeling on the vascular density of retinal capillary plexuses

Abstract

Relevance. Diabetic macular edema (DME) in combination with epimacular fibrosis (EMF) is an indication for vitreoretinal surgical treatment. The necessity of the retinal internal limiting membrane (ILM) peeling is debatable. The question of assessing the anatomy and function of the eyes in the early and late postoperative period is relevant, in particular, the study of the retinal capillary plexuses (RCP) characteristics such that its vascular density. The perpose of the study was to evaluate the presence and nature of the various ILM peeling methods effect on the RCP vascular density in patients with proliferative diabetic retinopathy and DME in combination with EMF in the early and late periods after treatment. Material and methods. A randomized case-control study was conducted on three comparable groups of patients. Surgical treatment was performed – vitrectomy with ILM peeling. The groups differed in the ILM peeling methods. In the early (1 month) and late (1 year) postoperative period, the RCP vascular density CAS was assessed, as well as the development of complications: DME, EMF recurrence, and retinal atrophy. Results. Statistically significant intra- and intergroup differences in the values of indicators of RCP vascular density during the entire period of observation were not revealed. It has been established that the initially higher vascular density in the superficial and deep RCP tends to remain at this level in the early and late postoperative period. Statistically significant relationships between RCP vascular density and the development of postoperative DME, recurrence of EMF or retinal atrophy have not been established. Conclusion. According to the results of our study, ILM peeling does not have a significant effect on the RCP vascular in the early and late postoperative period. The pathogenesis of postoperative complications and their relationship with the state of the RCP require further study. Keywords: vitreoretinal surgery, vitreomacular interface, retinal internal limiting membrane, dosed fovea-sparing ILM peeling, optical coherence tomography, optical coherence tomographyangiography, vascular density, automatic image analysis