Ichiyama Yusuke, Sawada Osamu, Mori Takamasa, Fujikawa Masato, Kawamura Hajime, Ohji Masahito
Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan.
Soseikai General Hospital, Kyoto, 612-8473, Japan.
Graefes Arch Clin Exp Ophthalmol. 2016 Aug;254(8):1545-1551. doi: 10.1007/s00417-015-3251-4. Epub 2016 Jan 18.
To investigate the effectiveness of vitrectomy for diffuse diabetic macular edema (DDME) and its dependence on optical coherence tomography (OCT) findings.
The records of 65 patients and 81 eyes who received vitrectomy for DDME and followed up for at least 6 months were retrospectively reviewed. All eyes were classified according to their morphological characteristics on OCT including sponge-like diffuse retinal thickening (SDRT: n = 13), cystoid macular edema (CME: n = 42), serous retinal detachment (SRD: n = 13), and the combination of all morphological characteristics (FULL: n = 13). The best-corrected visual acuity (BCVA) and spectral domain OCT were investigated preoperatively and at 1, 3, and 6 months postoperatively.
At six months after surgery, BCVA in logMAR units was significantly improved in all groups except the SDRT group. The improvement was -0.04 ± 0.20 in the SDRT group (P = 0.504), -0.16 ± 0.24 in the CME group (P < 0.01), -0.32 ± 0.32 in the SRD group (P < 0.01), and -0.26 ± 0.19 in the FULL group (P < 0.01), and significantly better in eyes with subretinal fluid (SRF; the SRD and FULL groups) than in eyes without SRF (the SDRT and CME groups, P = 0.003).
Vitrectomy can be a useful treatment option for DDME, particularly for eyes with SRF.
探讨玻璃体切除术治疗弥漫性糖尿病性黄斑水肿（DDME）的有效性及其对光学相干断层扫描（OCT）结果的依赖性。
回顾性分析65例患者81只接受DDME玻璃体切除术并随访至少6个月的病例记录。根据OCT上的形态学特征将所有眼睛分类，包括海绵状弥漫性视网膜增厚（SDRT：n = 13）、黄斑囊样水肿（CME：n = 42）、浆液性视网膜脱离（SRD：n = 13）以及所有形态学特征的组合（FULL：n = 13）。术前及术后1、3和6个月检查最佳矫正视力（BCVA）和光谱域OCT。
术后6个月，除SDRT组外，所有组的logMAR单位BCVA均有显著改善。SDRT组改善为-0.04±0.20（P = 0.504），CME组为-0.16±0.24（P < 0.01），SRD组为-0.32±0.32（P < 0.01），FULL组为-0.26± 0.19（P < 0.01），有视网膜下液（SRF；SRD组和FULL组）的眼睛比无SRF的眼睛（SDRT组和CME组）改善明显更好（P = 0.003）。
玻璃体切除术可能是DDME的一种有效治疗选择，特别是对于有SRF的眼睛。
