Clinical Study
Eye (2006) 20, 674–680. doi:10.1038/sj.eye.6701945; published online 21 October 2005
Pars plana vitrectomy for diabetic macular oedema: OCT and functional correlations
J I Patel1,2, P G Hykin1, M Schadt1, V Luong2, F Fitzke2 and Z J Gregor1
- 1Moorfields Eye Hospital, London, UK
- 2Department of Pathology, Institute of Ophthalmology, London, UK
Correspondence: JI Patel, Department of Pathology, Institute of Ophthalmology, 11-43 Bath St., EC1V 9EL London, UK. Tel: +44 207 608 6808; Fax: +44 207 608 6862; E-mail: jigs37@hotmail.com
Received 23 August 2004; Accepted 15 April 2005; Published online 21 October 2005.
Abstract
Purpose
A prospective study to evaluate the macular structural and functional effects of pars plana vitrectomy (PPV) for persistent diffuse clinically significant macular oedema (CSMO).
Method
A total of 12 patients with persistent diffuse CSMO were recruited and underwent assessment including best-corrected visual acuity, fundus fluorescein angiography, optical coherence tomography (OCT) and fine matrix mapping (FMM) at baseline and over a period of a year poststandard three-port PPV.
Results
The median baseline ETDRS letters score for all 12 patients was 52 (range 41–63) while at 12 months it had increased to 65 (range of 27–68), an improvement of two complete ETDRS lines (P=0.037). Similarly, there was an improvement in the perifoveal cone thresholds (P=0.02). The foveal thickening for all 12 patients ranged from a median of 183 to 751 
m (normal range 126–180 m) and the macular volume ranged from a median of 2.13 to 6.42 mm3 (normal <1.66 mm3). After surgery, both the median foveal thickness (from 334 to 280 m) and median macular volume (from 3.24 to 2.61 mm3) demonstrated decreases over 12 months (P=0.01). On baseline OCT, the patients fell into two anatomically distinct groups: Group 1 (n=4) had a dome-shaped thickened macula with a partial posterior hyaloid separation and a significantly higher foveal thickness and macular volume than Group 2 (n=8) which had a diffuse low-elevation profile of the thickened macula (P=0.007).
Conclusions
In this prospective study of PPV for persistent fovea-involving CSMO there was structural and functional improvement.
Keywords:
diabetes, macular oedema, pars plana vitrectomy, OCT
