Closure of macular hole following vitrectomy for diabetic tractional macular detachment

Shukla, Dhananjay; Dhoble, Pankaja; Jager, Rama D.; Aiello, Lloyd Paul; Ramasamy, Kim

doi:10.1038/sj.eye.6702226

Cited by 9 publications

(4 citation statements)

References 7 publications

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“…Earlier reports suggested that ILM peeling may not be necessary for MH closure in these eyes. [ 2 8 11 12 ] It was thought that the release of traction is sufficient for MH closure. However, as shown by the results of our as well as other recent studies, ILM peeling improves the outcomes in such eyes.…”

Section: Discussionmentioning

confidence: 99%

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Surgical outcome of full-thickness macular hole secondary to tractional retinal detachment in proliferative diabetic retinopathy

Ramasamy

Babu

Kohli

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To evaluate the surgical outcome of full-thickness macular hole (FTMH) secondary to active fibrovascular proliferation (FVP) and tractional retinal detachment (TRD) in eyes with proliferative diabetic retinopathy (PDR), and factors influencing the outcome. Methods: This retrospective study included the patients who underwent vitrectomy for FTMH secondary to PDR TRD from 2016 to 2020. Anatomical and visual outcomes were analyzed after six months along with the factors predicting the final outcome and duration of subretinal fluid (SRF) resolution. Results: Group A (macula-off combined RD, i.e., tractional and rhegmatogenous) included 10 eyes, while group B (macula-threatening TRD) included eight eyes. The mean best-corrected visual acuity improved from logMAR 1.21 (Snellen equivalent: 20/324) to logMAR 0.76 (Snellen equivalent: 20/115) ( P = 0.008). Seventeen patients gained ≥1 line(s) of vision. Mean visual gain in groups A and B was 3.7 ± 1.9 and 1.9 ± 1.1 lines, respectively ( P = 0.051). MH closed in 88.9% eyes. Type 1 anatomical closure was achieved in 88.9% of eyes. At 6 months, SRF and central macular thickness reduced from 479.6 ± 512.5 μm to 11.4 ± 23.5 μm ( P = 0.002) and 874.3 ± 422.6 μm to 207.6 ± 81.7 μm ( P = 0.0002), respectively. Finally, macular SRF resolved in all the patients. The mean duration for complete SRF resolution was 4.9 ± 3.2 months. Eyes with a shorter duration of diabetes mellitus (rho = −0.49, P = 0.040) and macula-off combined RD ( P = 0.048) took a longer time for complete SRF resolution. Conclusion: Good anatomical and visual outcomes can be achieved in eyes with PDR TRD-associated FTMH. The residual macular SRF resolves slowly after the surgery and extra intervention is not required. Macula-off combined RD is associated with worse outcome and a slower SRF resolution rate.

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Section: Discussionmentioning

confidence: 99%

“…[ 2 3 4 7 8 ] Another controversy related to the management of such eyes is the role of internal limiting membrane (ILM) peeling. [ 2 8 11 12 ]…”

mentioning

confidence: 99%

Surgical outcome of full-thickness macular hole secondary to tractional retinal detachment in proliferative diabetic retinopathy

Ramasamy

Babu

Kohli

et al. 2021

Indian Journal of Ophthalmology

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“…Bu gözlerde, çekintiye neden olan fibrovasküler doku veya sıkı arka hyaloid cerrahi ile uzaklaştırıldığında makula deliği sıklıkla kapanmakta ve idiyopatik makula deliği cerrahisinde rutin uygulamaya giren İLM soyulması işleminin mutlaka gerekli olmadığı belirtilmektedir. 4,6 Delik kapanma oranı yüksek olsa bile altta yatan makula iskemisi ile ödeme bağlı makula hasarı veya uzun süreli makula dekolmanının varlığı nedeniyle görme artışı sınırlı olmaktadır. 3 Ghoraba, 3 çalışmasındaki olgularından hiçbirinde son görme keskinliğinin 0,2'den daha yüksek olmadığını rapor etmiştir.…”

Section: Discussionunclassified

Proliferatif Diyabetik Retinopatide Makula Deliği Gelişimine Yol Açan Farklı Mekanizmalar

...

2012

Tjo

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“…Studies have described more than 90% anatomical closure of the macular holes when PPV was combined with ILM peeling [5]. Management of MH in PDR has been described; however, few studies about MH treatment associated with PDR were carried out with only few reports have studied the efficacy of ILM peeling in such cases [6].…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study of Vitrectomy with and Without Internal Limiting Membrane Peeling In Diabetic Macular Holes

Bessa¹

2018

IJOAO

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Context: To clarify if Internal Limiting Membrane (ILM) peeling during Para Plana Vitrectomy (PPV) for diabetic macular hole can improve the visual and anatomical outcome of Diabetic Macular Holes (DMH). Design: Prospective case-control study. Participants: 60 eyes of 60 diabetic patients with DMH. Methods: 30 eyes underwent PPV with ILM peeling (group 1), while PPV only was performed in the other 30 eyes (group 2) with DMH. Closure of the macular hole and visual acuity were assessed and compared at the end of the six postoperative months. Results: Anatomical closure was achieved in 15 of group 1 eyes, while it was statistically significant higher in group 2 eyes (24 eyes). Eyes which underwent ILM peeling achieved statistically significant more visual gain than eyes with no ILM peeling with 18 and 10 eyes improved two or more Senellen lines in group 2 and group 1, respectively. Conclusion: visual outcome and anatomical closure of diabetic macular holes were significantly higher in eyes where ILM peeling was performed compared to the other group. Accordingly, bimanual dissection of ILM during PPV may be mandatory to achieve better visual prognosis and anatomical outcome in eyes with diabetic macular holes.

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Closure of macular hole following vitrectomy for diabetic tractional macular detachment

Cited by 9 publications

References 7 publications

Surgical outcome of full-thickness macular hole secondary to tractional retinal detachment in proliferative diabetic retinopathy

Surgical outcome of full-thickness macular hole secondary to tractional retinal detachment in proliferative diabetic retinopathy

Proliferatif Diyabetik Retinopatide Makula Deliği Gelişimine Yol Açan Farklı Mekanizmalar

A Comparative Study of Vitrectomy with and Without Internal Limiting Membrane Peeling In Diabetic Macular Holes

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