Incidence, Risk Factors and Effect on Outcomes of Microcystic Macular Edema After Pars Plana Vitrectomy for Retinal
Marco Pellegrini1, Ginevra Giovanna Adamo1, Antonio Cartabellotta1
1From the Department of Translational Medicine (M.P., G.A., A.C., M.Z., F.P., M.M.), University of Ferrara, Ferrara, Italy; Department of Ophthalmology (M.P., G.A., A.C., M.Z., P.T., F.N., L.S., F.P., M.M.), Sant'Anna University Hospital, Ferrara, Italy.
Purpose:
The purpose of this study was to evaluate the incidence, risk factors and clinical significance of microcystic macular edema (MME) after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).
Design:
Interventional case series.
Methods:
Clinical charts of patients who underwent PPV for RRD were retrospectively reviewed. MME was diagnosed with optical coherence tomography in presence of small, nonconfluent elliptical cystoid spaces located at the level of the inner nuclear layer and sparing other retinal layers and the foveal center. The potential relationship between clinical and surgical variables and the occurrence of MME was evaluated with a multiple logistic regression.
Results:
A total of 318 eyes which underwent PPV for RRD were included. In total, 35 eyes (11.0%) presented cystoid changes consistent with MME, while 93 (29.2%) showed "typical" cystoid macular edema. Silicone oil tamponade was significantly associated with the occurrence of MME (P = .010). Best-corrected visual acuity did not differ significantly between eyes with and without MME (0.44 ± 0.54 versus 0.71 ± 0.76 logMAR; P = .103).
Conclusions:
This study found an incidence of 11% of MME following vitrectomy for RRD. Although MME was significantly associated with silicone oil tamponade, it showed no relationship with postoperative visual outcomes. Thus, no anti-inflammatory treatment may be required.
Insights
Microcystic macular edema (MME) occurred in 11% of patients after vitrectomy for retinal detachment. While linked to silicone oil, MME did not impact visual outcomes, suggesting anti-inflammatory treatment may not be necessary.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Macular Edema
Background:
- Rhegmatogenous retinal detachment (RRD) is a serious condition requiring surgical intervention.
- Pars plana vitrectomy (PPV) is a common surgical procedure for RRD.
- Macular edema can be a postoperative complication, potentially affecting visual acuity.
Purpose of the Study:
- To determine the incidence of microcystic macular edema (MME) after PPV for RRD.
- To identify risk factors associated with MME development.
- To evaluate the clinical significance and visual outcomes in patients with MME.
Main Methods:
- Retrospective review of clinical charts from 318 eyes undergoing PPV for RRD.
- Diagnosis of MME using optical coherence tomography, characterized by specific cystoid space morphology.
- Multiple logistic regression analysis to assess the relationship between clinical/surgical variables and MME occurrence.
Main Results:
- The incidence of MME was 11.0% (35 eyes), compared to 29.2% for typical cystoid macular edema.
- Silicone oil tamponade was significantly associated with the development of MME (P = .010).
- No significant difference in best-corrected visual acuity was observed between eyes with and without MME (P = .103).
Conclusions:
- Microcystic macular edema (MME) is an 11% incidence complication following vitrectomy for RRD.
- MME is associated with silicone oil use but does not adversely affect postoperative visual outcomes.
- The lack of impact on visual outcomes suggests that anti-inflammatory treatment for MME may not be required.
