Vitrectomy for Diffuse Macular Edema in Cases of Diabetic Retinopathy

Tachi, Naoko; Ogino, Nobuchika

doi:10.1016/s0002-9394(14)72018-5

Cited by 251 publications

(153 citation statements)

References 4 publications

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“…Because of its rarity and difficult diagnosis, most studies on this condition are limited to small series. Some authors [153,154,155,156] reported positive outcomes in up to 90% of eyes, with visual acuity improving to 5/10 or more in almost 30%. However, the benefits seem to be short-lived, as acuity can drop again in the medium-long term and the indications for surgery in diabetic macular edema have yet to be established more firmly.…”

Section: Macular Edemamentioning

confidence: 99%

Diabetic retinopathy

2002

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Abstract. Easy observation of the fundus oculi makes retinopathy the most frequently reported chronic complication of diabetes and, consequently, the one we know best in terms of epidemiology and natural history. Achieving near-normal levels of blood glucose and blood pressure provides empirical though powerful tools for clinicians to delay the onset and progression of diabetic retinopathy. Even when these measures have failed and retinopathy becomes sight-threatening, laser photocoagulation has proven remarkably effective. Nonetheless, retinopathy remains a leading cause of blindness and there is little evidence that diabetes-related visual loss is decreasing in industrialized countries. This may result from the mixed blessing of prolonged survival of patients who had become diabetic when metabolic control was pursued less fastidiously than today. Screening for sight-threatening retinopathy is the most cost-effective medical procedure known and should help optimise the use of diagnostic and therapeutic resources, but its widest deployment still meets with inertia and lack of interest within most health care systems. Improving clinical skills and technology, however, allow us to take a more optimistic look at the future, as pathogenesis-targeted forms of treatment are being developed and tested through appropriately powered clinical trials. [Diabetologia (2002[Diabetologia ( ) 45:1617[Diabetologia ( -1634

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Section: Macular Edemamentioning

confidence: 99%

Diabetic retinopathy

2002

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“…Performing vitrectomy without ILM peeling in eyes with no evident vitreomacular traction, LaHeij et al 3 reported resolution of DMO in 21 of 21 eyes while Tachi and Ogino 4 reported resolution of DMO in 57 of 58 eyes. These favourable results make ILM removal be questionable.…”

Section: Discussionmentioning

confidence: 99%

“…2 The role of vitreoretinal traction in the pathogenesis of DMO as well as positive impact of vitrectomy and removal of internal limiting membrane (ILM) on DMO has been known. [3][4][5][6] Triamcinolone-assisted posterior vitreous separation is also beneficial for DMO. 7,8 We compared the efficacy of indocyanine green (ICG)-assisted ILM peeling and triamcinolone-assisted posterior vitreous separation in terms of best-corrected visual acuity (BCVA) in DMO.…”

Section: Introductionmentioning

confidence: 99%

Comparison of ICG-assisted ILM peeling and triamcinolone-assisted posterior vitreous removal in diffuse diabetic macular oedema

Bardak

Çekıç

Tiğ

2005

Eye

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Aim To compare the effect of indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling and triamcinolone acetonide-assisted posterior vitreous removal on visual acuity in patients with diffuse diabetic macular oedema (DMO). Methods In total, 24 patients with diffuse DMO who underwent pars plana vitrectomy were included in this study. In all, 11 patients (mean age 57 years) were performed ICGassisted ILM peeling; while 13 patients (mean age 54 years) underwent triamcinoloneassisted posterior vitreous removal. Patients from two different treatment regimens were compared in terms of best-corrected visual acuity (BCVA) at postoperative sixth months. Results In ICG-assisted ILM peeling group, preoperative BCVA (1.370.4, mean7SD, logMAR) improved postoperatively to 0.970.5 (P ¼ 0.011). In eyes underwent triamcinoloneassisted posterior vitreous removal, baseline BCVA of 1.470.4 improved to 1.070.5 (P ¼ 0.007). There was no difference between baseline as well as postoperative sixth-month BCVA results of both groups (P ¼ 0.59 and P ¼ 0.57, respectively). Conclusions Triamcinolone-assisted posterior vitreous removal and ICG-assisted ILM peeling have the same effect in terms of postoperative BCVA in patients with diffuse DMO.

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“…It has also been suggested that macular oedema tends to show actual worsening in eyes afflicted with DR at the time of cataract surgery. 14 Distinguishing transient oedema from substantial progression of maculopathy is important to the timing of treatment for the macular oedema, including laser photocoagulation, 31 vitrectomy, [32][33][34] and triamcinolone injection. [35][36][37] However, until recently, there had been no quantitative study to examine the progression of diabetic macular oedema after cataract surgery.…”

Section: Introductionmentioning

confidence: 99%

Changes in diabetic macular oedema after phacoemulsification surgery

Hayashi

Igarashi

Hirata

et al. 2007

Eye

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Purpose To quantitatively examine changes in macular oedema after phacoemulsification surgery in eyes with diabetic retinopathy (DR) and in eyes without DR. Methods Thirty-four eyes with DR and 34 eyes with no DR scheduled for phacoemulsification surgery were recruited. Foveal thickness and macular volume were measured using optical coherence tomography preoperatively and at 3, 6, and 12 months postoperatively. Grade of diabetic macular oedema was also examined. Results Preoperatively, there were no significant differences between groups in foveal thickness and macular volume. The foveal thickness increased by 20.3% in the DR group and by 6.0% in the no DR group at 3 months after surgery, but thereafter decreased gradually. When comparing the groups, the foveal thickness and macular volume were significantly greater in the DR group than in the no DR group at 3 months postoperatively. The grade of macular oedema worsened in eight eyes (23.5%) in the DR group, and in one (2.9%) in the no DR group: the incidence was significantly greater in the DR group (P ¼ 0.0272). However, the oedema that occurred after surgery resolved spontaneously in three (33.3%) of the nine eyes. Conclusions The degree of diabetic macular oedema increases up to 3 months after cataract surgery, but thereafter decreases gradually. Grade of diabetic macular oedema also worsens up to 3 months, but certain percent of macular oedema that occurs after surgery resolves spontaneously. These changes are more prominent in eyes with DR than in eyes with no DR.

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Vitrectomy for Diffuse Macular Edema in Cases of Diabetic Retinopathy

Cited by 251 publications

References 4 publications

Diabetic retinopathy

Diabetic retinopathy

Comparison of ICG-assisted ILM peeling and triamcinolone-assisted posterior vitreous removal in diffuse diabetic macular oedema

Changes in diabetic macular oedema after phacoemulsification surgery

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