Extrafoveal vitreous traction associated with diabetic diffuse macular oedema

Abstract

Purpose To present an association between diabetic diffuse macular oedema and extrafoveal vitreous traction by optical coherence tomography (OCT). Methods In a retrospective study, charts and OCT scans of diabetic patients with macular oedema were reviewed. Eyes with either vitreofoveal or extrafoveal traction were included. Eyes that had vitreoretinal adherence with no sign of traction, idiopathic vitreomacular traction syndrome, or vitreoretinal surgery were excluded. Macular maps were compared with normal controls (n ¼ 12). Results Of the 186 eyes of 122 consecutive patients, 45 eyes (41 patients) were analyzed. Vitreofoveal traction was detected in 25 eyes (56%) and extrafoveal traction in 20 (44%), either at the retina (16; 35%) or at the optic nerve head (4; 9%). Of these 20 eyes, related extrafoveal retinal oedema was in continuum with the central macular oedema, manifesting as diffuse macular oedema, in 16 (36% of all 45) eyes. Vitreous adherence was detected by the centrally fixated Automatic 6-radial lines program in 26 eyes (58%): 5 (25%) of 20 with extrafoveal traction and 21 (84%) of 25 with vitreofoveal traction. In the other 19 (42%) eyes, the vitreous traction site was detected only by the Line group OCT-2000 program, which is manually controllable during the scanning process.Conclusions Diabetic diffuse macular oedema may be related to an extrafoveal vitreous traction. The traction sites were detected in a large proportion of eyes only by the OCT Line group program and not by the Automatic 6-radial lines program. Further studies are required to validate the clinical consequence of these findings.

Vitreous traction and epiretinal membranes in diabetic macular oedema using spectral-domain optical coherence tomography

“…Vitreomacular traction. 6 Its prevalence in the larger series on DME ranged between 4% of eyes (6/140, described as a taut thickened posterior hyaloid), 7 13.4% (25/186 eyes) 8 and 25% (12/48 eyes; described as vitreoretinal adhesions). 9 Pars plana vitrectomy (PPV) was generally found to be beneficial in these cases.…”

“…8 3. Studies noted a prevalence of epiretinal membrane (ERM) that ranged between 27% 13 and 34% 9 in eyes with DME.…”

“…The limitations of the time-domain OCT instruments in the detection of vitreous traction membranes 8 and ERMs 23 led to the purpose of this study, to use 3D spectral domain OCT (SD-OCT) to determine the prevalence of vitreous traction membranes and ERMs in eyes with DME. To the best of our knowledge (search through Entrez PubMed), this is the first report using SD-OCT in relation to this issue.…”

Extrafoveal traction in retinal vein occlusion using spectral domain optical coherence tomography

“…Following the relative limitation of detecting extrafoveal traction membranes by time-domain OCT [34,35], the contributions of the B-mode video and the 3-D image reconstruction of the SD-OCT in the plain detection of extrafoveal traction sites and their association with the central macular oedema in eyes with RVO is reported herein.…”

“…Extrafoveal vitreous traction associated with diabetic macular oedema was recently found in 10.8% (20/186) of eyes using time-domain OCT [34], while its prevalence was found to be 3-fold more common (34.5%; 20/58) when examined with SD-OCT [35]. Following the relative limitation of detecting extrafoveal traction membranes by time-domain OCT [34,35], the contributions of the B-mode video and the 3-D image reconstruction of the SD-OCT in the plain detection of extrafoveal traction sites and their association with the central macular oedema in eyes with RVO is reported herein.…”