Diabetic traction retinal detachment. Factors influencing final visual acuity

Area of Science:

• Ophthalmology
• Retinal Surgery
• Diabetic Retinopathy

Background:

• Diabetic traction retinal detachment (TRD) is a complex complication of proliferative diabetic retinopathy.
• Vitreous surgery is a primary treatment for TRD, but case selection remains crucial for optimal outcomes.

Purpose of the Study:

• To identify key parameters for improving patient selection in vitreous surgery for diabetic TRD.
• To evaluate the prognostic significance of retinal detachment configuration and preoperative visual acuity.

Main Methods:

• Statistical analysis of eyes with clear media and diabetic TRD undergoing vitreous surgery.
• Assessment of various detachment configurations (hammock, flat diffuse central, table-top, tent-shaped) and retinopathy activity.
• Evaluation of preoperative visual acuity and outcomes following preretinal membranectomy.

Main Results:

• Hammock and flat diffuse central detachments showed a good prognosis, while elevated, atrophic detachments had a poor prognosis.
• Eyes with inactive diabetic retinopathy and better preoperative vision ( > 5/200) achieved significantly better surgical outcomes.
• Preretinal membranectomy, despite increased iatrogenic tears, proved beneficial for complex TRD, expanding surgical eligibility.

Conclusions:

• Retinal detachment configuration and preoperative visual acuity are critical factors in predicting surgical success for diabetic TRD.
• Preretinal membranectomy plays a vital role in managing complex traction detachments, improving the number of eyes benefiting from surgery.
• Refined case selection based on these parameters can optimize outcomes for patients undergoing vitreous surgery for diabetic TRD.