Vitrectomy for Persistent Diffuse Diabetic Macular Edema - 18/08/11
, Susanne Binder, MD a, b, Diego Gruber c, Ilse Krebs, MD a, b, Tina Aggermann, MD b, Beatrix Neumaier, MD a, b
Inquiries to Ulrike Stolba, MD, Department of Ophthalmology, Rudolf Foundation Clinic, Juchgasse 25, A 1030 Vienna, Austria; fax: 00431 71165 4609Résumé |
Purpose |
To evaluate the potential benefit of vitrectomy in eyes with persistent diffuse macular edema.
Design |
Prospective randomized comparative clinical trial.
Methods |
Eyes with diffuse diabetic macular edema for 6 to 18 months, an attached posterior hyaloid, and grid laser photocoagulation performed at least 4 months before were included. Patients were randomized either to a vitrectomy group or to a control group. main outcome measures: Evaluations of Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity, reading vision, and retinal thickness were carried out at baseline and 1, 3, and 6 months after enrollment.
Results |
Fifty-six eyes (100%) were enrolled in this study. Twenty-five eyes (44.6%) were randomized into Gr I (vitrectomy group) and 31 eyes (55.4%) into Gr II (controls). Both groups were comparable in mean age (62.7 years and 63.9 years) and distribution of gender (one third male, two thirds female).
ETDRS visual acuity showed a statistical significance in favor of Gr I at all time points (P = .035 to .005 Fisher′s exact test). With Jaeger charts a significance for Gr I was found only at the 6-month examination (P = .01). With optical coherence tomography, the different behavior of retinal thickness changes in both groups during follow-up was statistically significant; P values were <.0001 for month 1, 3, and 6, preferring Gr I.
Conclusions |
We provide evidence that vitrectomy with internal limiting membrane peeling is superior to observation alone in eyes with persistent diffuse diabetic macular edema for 6 to 18 months. Longer follow-up periods and larger series might be needed to confirm these results and gain additional information.
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Vol 140 - N° 2
P. 295.e1-295.e9 - août 2005 Retour au numéro
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