Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.
Ophthalmologica. 2022;245(5):446-454. doi: 10.1159/000524742. Epub 2022 Apr 27.
The aim of the study was to compare anatomical and functional outcomes of pars plana vitrectomy (PPV) with epiretinal membrane (ERM) peeling in diabetes retinopathy patients with and without diabetic macular edema (DME).
A retrospective interventional case series of consecutive patients who underwent PPV with ERM peeling. Patients were divided into two groups: those with and without preoperative DME. Visual acuity (VA) and optical coherence tomography parameters were evaluated before surgery and during 12 months of follow-up.
A total of 354 patients underwent PPV with ERM peeling, of which 51 met the inclusion criteria. Twenty-three were diagnosed with DME and were younger (66.3 ± 9.6 vs. 73.1 ± 8.2 years, p = 0.001), had longer diabetes mellitus (DM) duration (18.9 ± 7.1 vs. 14.3 ± 10.9 years, p = 0.04) and higher HbA1C% (7.6 ± 1.4 vs. 7.1 ± 1.3, p = 0.04). VA improved from 20/105 to 20/60 Snellen (p = 0.004) and central macular thickness decreased from 469.3 ± 64.9 μm to 331.1 ± 92.2 μm (p < 0.001) in the DME group and from 20/87 to 20/44 Snellen (p < 0.001) and from 463.1 ± 53.5 μm to 341.3 ± 49.5 μm (p = 0.01) in the non-DME group. Yearly intravitreal injection rate decreased from 5.9 ± 2.5 to 2.9 ± 3.0 (p < 0.001) injections in the DME group.
DME patients with ERM experience significant improvement in VA, macular thickness, and yearly intravitreal injections after PPV with ERM peeling. DME patients are younger, with longer duration of DM and higher HbA1C% levels at presentation in comparison to diabetic ERM patients without DME.
本研究旨在比较合并与不合并糖尿病性黄斑水肿（DME）的糖尿病性视网膜病变患者行视网膜前膜（ERM）剥除的玻璃体切除术（PPV）的解剖和功能结果。
回顾性连续接受 PPV 联合 ERM 剥除的患者的干预性病例系列研究。患者分为两组：术前有 DME 组和无 DME 组。在术前和术后 12 个月评估视力（VA）和光学相干断层扫描（OCT）参数。
共 354 例行 PPV 联合 ERM 剥除的患者，其中 51 例符合纳入标准。23 例被诊断为 DME，且更年轻（66.3±9.6 岁 vs. 73.1±8.2 岁，p=0.001）、糖尿病病程更长（18.9±7.1 岁 vs. 14.3±10.9 岁，p=0.04）、糖化血红蛋白（HbA1C）%更高（7.6±1.4% vs. 7.1±1.3%，p=0.04）。DME 组 VA 从 20/105 提高到 20/60 Snellen（p=0.004），黄斑中心厚度从 469.3±64.9μm 下降到 331.1±92.2μm（p<0.001），非 DME 组 VA 从 20/87 提高到 20/44 Snellen（p<0.001），黄斑中心厚度从 463.1±53.5μm 下降到 341.3±49.5μm（p=0.01）。DME 组每年玻璃体腔内注射次数从 5.9±2.5 下降到 2.9±3.0（p<0.001）。
与不合并 DME 的糖尿病性 ERM 患者相比，合并 DME 的患者在接受 ERM 剥除的 PPV 后 VA、黄斑厚度和每年玻璃体腔内注射次数均显著改善。与不合并 DME 的糖尿病性 ERM 患者相比，DME 患者更年轻，糖尿病病程更长，HbA1C%水平更高。
