Fluid Aspiration From Intraretinal Cysts for Refractory Diabetic Macular Edema
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Updated: May 23, 2025

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Keijiro Ishikawa1, Shintaro Nakao2, Kenichiro Mori1
1Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan ; and.
Purpose:
To report the surgical outcome of fluid aspiration in intraretinal cysts as a novel treatment approach for the refractory cystoid macular edema associated with diabetic retinopathy.
Methods:
This retrospective consecutive case series examined eight patients with refractory cystoid macular edema who underwent intraretinal cyst fluid aspiration using a 38-gauge subretinal infusion needle during pars plana vitrectomy. This study reviewed changes in central retinal thickness, best-corrected visual acuity, and central sensitivity among patients followed up for 12 months postsurgery.
Results:
Central retinal thickness on optical coherence tomography (microm) significantly improved at 12 months after surgery (308 ± 99) compared with before surgery (480 ± 141) ( P < 0.005). During the follow-up period, cystoid macular edema relapsed in one eye. The best-corrected visual acuity (logarithm of the minimal angle of resolution) at 12 months postsurgery (0.23 ± 0.32, Snellen equivalent: 20/50) was significantly better than the preoperative best-corrected visual acuity (0.39 ± 0.29, Snellen equivalent: 20/63) ( P < 0.01). The mean deviation value of central sensitivity did not significantly change between preoperative (-2.5 ± 2.1) and postoperative (-2.2 ± 2.2) assessments ( P = 0.07).
Conclusion:
Fluid aspiration in intraretinal cysts may be a treatment option for refractory cystoid macular edema in eyes with diabetes.
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