Vitrectomy in Diabetic Macular Edema:: A Swept-source OCT Angiography Study

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Diabetic macular edema (DME) is a leading cause of vision loss.
• Anti-VEGF injections are a common treatment, but their long-term effects on the foveal avascular zone (FAZ) are noted.
• Surgical interventions like vitrectomy are also employed for DME management.

Purpose of the Study:

• To investigate the changes in the foveal avascular zone (FAZ) using swept-source OCT angiography after vitrectomy in patients with DME.
• To evaluate the impact of vitrectomy on retinal thickness and vessel density in DME patients.

Main Methods:

• A retrospective interventional study involving 35 eyes of patients with DME.
• Patients underwent vitrectomy with internal limiting membrane peeling.
• Follow-up was conducted for 12 months, measuring central retinal thickness (CRT), choroidal thickness, superficial and deep FAZ (dFAZ), and superficial and deep vessel density (dVD).

Main Results:

• Significant decreases in CRT and superficial FAZ were observed post-surgery (P < 0.001).
• Initial visual acuity (VA) improved significantly from 0.97 to 0.62 LogMAR (P < 0.001).
• Superficial vessel density showed a slight decrease, while deep vessel density (dVD) remained stable post-surgery.

Conclusions:

• Vitrectomy leads to a reduction in superficial FAZ in DME patients, potentially offering a protective effect similar to anti-VEGF treatments.
• Predictors for better final VA include better preoperative VA, lower preoperative CRT, and favorable dFAZ and dVD at edema resolution.