Electron Immunocytochemical Analysis of Posterior Hyaloid Associated With Diabetic Macular Edema

Abstract

The thickened, taut posterior hyaloid observed in our patients with diabetic macular edema contained cells of glial and epithelial origin. This cellular infiltration may contribute to abnormal vitreomacular adherence and could play a role in the pathogenesis of macular edema in some patients with diabetes.

Visualizing vitreous in vitrectomy by triamcinolone

“…Indeed, in diabetic retinopathy, a diffuse thin hyaloid cortex was frequently left even after surgical PVD, which is seen with the help of TA suspension [15,27]. Several retrospective clinical studies showed that vitrectomy and removal of the posterior hyaloid lead to visual improvement [53][54][55][56][57][58][59][60][61][62]. In a larger series without randomization, a functional benefit after vitrectomy was described in approximately 50% of the cases.…”

Current Treatment Approaches in Diabetic Macular Edema

“…Previous investigators reported a positive impact of pars plana vitrectomy in DME [25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64]. Vitrectomy with removal of the premacular posterior hyaloid may resolve the DME and improve vision in patients who previously failed to respond to conventional laser treatment.…”

“…In the following years, numerous retrospective studies have shown the advantage of vitrectomy and removal of the posterior hyaloid on morphologic and functional results [34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65]. Harbour et al [35], Pendergast [36] and Kaiser et al [39] evaluated the surgical results in patients with a thickened and taut posterior hyaloid membrane in combination with DME and stated that early surgical intervention may result in better visual outcome.…”

Macular Edema Surgical Treatment

“…This pool of agents can cause cell migration to the posterior hyaloid. Contraction of these cells could lead to macular traction with possible development of a shallow macular detachment and exacerbation of ME [9,10] . (Fig.…”