Macular Morphology in Patients With Diabetic Retinopathy Treated by ILM Peeling: A Propensity Score-Matched Analysis

To analyze the effects of vitrectomy combined with internal limiting membrane (ILM) peeling in patients with diabetic retinopathy (DR) by propensity score-matched analysis.

Patients with proliferative DR that underwent pars plana vitrectomy were divided into two groups: without or with additional ILM peeling. Propensity score-matched analyses of variables were carried out. Optical coherence tomography (OCT) was conducted at the 6-month follow-up. The primary outcome measures were epiretinal membrane (ERM), intraretinal cystic changes, recurrent macular edema, and blurring of the inner segment/outer segment (IS/OS) margin.

There were 41 patients in Group 1 (non-ILM peeling) and 41 patients in Group 2 (ILM peeling). ERM was observed in 11 of 41 eyes (26.8%) in Group 1, and three of 41 eyes (7%) in Group 2 at the 6-month follow-up (P = .019). Intraretinal cystoid changes were observed in 13 eyes of Group 1 and four eyes of Group 2 (P = .014). The median central macular thickness was 250.00 ± 135.09 μm in Group 1 and 235.00 ± 101.55 μm in Group 2 (P = .738). Macular edema was observed in 24 eyes (58.5%) in Group 1 and 19 eyes (46.3%) in Group 2 (P = 0.269). There was no significant difference in foveal dip angle between the groups (P = .820). The IS/OS margin was disrupted in 48.8% and 56.1% of eyes in Groups 1 and 2, respectively, without significant difference. There was also no significant difference in best-corrected visual acuity (BCVA) between two groups before surgery, and there was no significant difference in BCVA between two groups at 6 months after surgery (P = .13).

The authors' results indicate that vitrectomy combined with ILM peeling can minimize ERM formation and eliminate intraretinal cystoid changes, but the functional recovery is limited. [.