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¹Beyoğlu Göz Eğitim ve Araştırma Hastanesi, 4. Göz Kliniği, İstanbul, Prof. Dr.
²Beyoğlu Göz Eğitim ve Araştırma Hastanesi, 1. Göz Kliniği, İstanbul, Uz. Dr.
³Beyoğlu Göz Eğitim ve Araştırma Hastanesi, 4. Göz Kliniği, İstanbul, Uz. Dr.
⁴Erzincan Devlet Hastanesi, Göz Hastalıkları Kliniği, Erzincan, Uz. Dr.
⁵Beyoğlu Göz Eğitim ve Araştırma Hastanesi, 4. Göz Kliniği, İstanbul, Asist. Dr. Purpose: To evaluate associations between optical coherence tomography (OCT) findings and visual outcomes after 23 gauge vitrectomy for diabetic patients with secondary epiretinal membrane.
Materials and Methods: Forty-three eyes of 43 patients who were operated on with 23 gauge vitrectomy for ERM and diabetic macular edema with a period of at least 6 months’ follow-up were investigated. The effects of surgery on postoperative 6 month visual acuity (VA) and macular thickness changes, and the associations between preoperative OCT findings (central macular thickness (CMT), presence of subfoveal exudate and detachment, foveal cyst, pseudohole and vitreomacular traction, the pattern of membrane adherence) and postoperative VA improvement and CMT change were studied.
Results: Visual acuity improved 0.30 logMAR unit and was better in 39 eyes, and less than 0.30 logMAR unit in 4 patients. There were no significant associations between preoperative CMT, presence of subfoveal exudate and detachment, foveal cyst, pseudohole, vitreomacular traction, and VA change (p>0.05). When the same parameters’ effects were evaluated on CMT change, significant associations only with foveal cyst and preoperative CMT were detected. A significant difference was detected between the diffuse adherence pattern and mixed adherent patterns of ERMs on postoperative VA improvement (p=0.05). There were no significant associations between postoperative CMT change and VA change (p=0.35).
Conclusion: 23 Gauge PPV provided 90.7% effective VA improvement in cases of diabetic maculopathy with ERM. No significant associations were detected between postoperative CMT change and VA change. Preoperative CMT and presence of foveal cyst affected postoperative CMT change significantly. In patients with ERM with both diffuse and focal adherence pattern the VA improvement was better than that in patients with diffusely adherent membranes. Keywords : Epiretinal membrane, 23 gauge vitrectomy, optical coherence tomography