Macular morphologic findings on optical coherence tomography after microincision vitrectomy for proliferative diabetic retinopathy.

PURPOSE

To investigate macular morphology on spectral-domain optical coherence tomography (SD-OCT) images after microincision vitrectomy for vitreous hemorrhage associated with proliferative diabetic retinopathy (PDR).

METHODS

In this retrospective case series, 69 eyes (57 consecutive patients) that underwent 23-gauge microincision vitrectomy for vitreous hemorrhage due to PDR were investigated. Qualitative and quantitative characteristics on SD-OCT images [central retinal thickness, external limiting membrane (ELM), and the ellipsoid zone, epiretinal membranes involving the fovea, and hyperreflective foci at the fovea] were assessed 6 months postoperatively. Their association with the logarithm of the minimum angle of resolution visual acuity (logMAR VA) was evaluated.

RESULTS

The ELM was disrupted in 15 and the ellipsoid zone in 27 eyes, and associated significantly (P < 0.001, for both comparisons) with poor visual outcomes 6 months postoperatively. Hyperreflective foci in the outer retinal layers were associated with either a disrupted ELM or ellipsoid zone and poor prognoses (P < 0.001, for all comparisons). The accumulation of hyperreflective foci at the fovea in five eyes was correlated significantly (P < 0.001) with poorer logMAR VA. Twenty-nine eyes had center-involved diabetic macular edema 6 months postoperatively, whereas the central thickness was not correlated with the logMAR VA (R = -0.148, P = 0.224). Eight eyes with either epiretinal membrane on SD-OCT images had greater central thickness (P = 0.003), although there were no differences in the logMAR VA between eyes with and without it (P = 0.648).

CONCLUSIONS

Foveal photoreceptor damage is associated with poor visual outcomes after microincision vitrectomy for vitreous hemorrhage due to PDR.