Predictability of vitreous detachment following intravitreal plasmin injection in diabetic macular edema associated with vitreomacular traction.

PURPOSE

To assess preoperative factors associated with postoperative posterior vitreous detachment (PVD) following intravitreal autologous plasmin injection in diabetic macular edema associated with vitreomacular traction.

METHODS

Twenty-five eyes with diabetic macular edema associated with vitreomacular traction as documented with optical coherence tomography were included. Approximately 0.2 IU/0.2 ml of autologous plasmin was injected intravitreally. Condition of the posterior vitreous face (degree of detachment, thickness, reflectivity, and diameter of attached vitreous base) was evaluated preoperatively and postoperatively up to 3 months.

RESULTS

PVD was achieved in ten eyes (41.7%). There was a significant difference (P = 0.03) in mean posterior vitreous face thickness between the eyes with PVD and the eyes with failed PVD. There was a significant correlation between PVD and both posterior vitreous face thickness (P < 0.03%) and degree of posterior vitreous face reflectivity (P = 0.002).

CONCLUSION

In diabetic eyes with vitreomacular traction, the prediction of PVD after plasmin injection is governed by the condition of posterior vitreous face; mainly posterior vitreous face thickness and reflectivity. Eyes with thinner, less reflective posterior vitreous face are more likely to develop PVD.