Macular microstructure and relation with visual prognosis of micro-invasive vitrectomy for diabetic vitreous hemorrhage

Abstract

Objective To investigate the relationship of macular microstructure and visual prognosis of micro-invasive vitrectomy for diabetic vitreous hemorrhage.Methods Fifty-three patients (53 eyes) with diabetic vitreous hemorrhage who underwent micro-invasive vitrectomy were enrolled in this retrospective study.The preoperative and postoperative best-corrected visual acuities (BCVA) were recorded.The central foveal thicknesses (CFT) were measured after surgery by spectral domain-optical coherence tomography (SD-OCT).The median follow-up time was (12.81-8.22) months,ranging from six to 36 months.According to the results of SD-OCT at last follow-up time,macular edema (ME),epiretinal membrane (ERM),interrupted inside and outside section (IS/OS) and interrupted external limiting membrane (ELM) were macular abnormalities were observed.The preoperative and postoperative BCVA of different macular abnormalities were comparatively analyzed.The correlation between BCVA and macular microstructure were analyzed.Results The CFT was ranged from 103.00 μm to 498.00 μm,with the mean of(251.12 ±90.23) μm.Macular abnormalities were observed in 37 eyes (69.8％),and normal macula in 16 eyes (30.2％).Among 37 eyes with macular abnormalities,there were 20 eyes (37.7％) with ME,12 eyes (22.6％) with ERM,33 eyes (62.3％) with interrupted IS/OS,and 20 eyes (37.7％) with interrupted ELM.The BCVA of ME eyes decreased significantly than that in non-ME eyes (t=-2.09,P＜0.05).The difference of BCVA in ERM and non-ERM eyes was not statistically significant (t=-1.10,P＞0.05).The BCVA of interrupted IS/OS eyes decreased significantly more than that in continuous IS/OS eyes (t=-4.33,P＜0.05).The BCVA of interrupted ELM eyes decreased significantly more than that in continuous ELM eyes (t=-2.58,P＜ 0.05).The postoperative BCVA correlated positively with integrity of the IS/OS junction,CFT,and whether ME or not (r=7.65,8.21,4.99; P＜0.05),but insignificantly associated with integrity of the ELM and whether ERM or not (r=0.01,0.82; P＞0.05).Conclusion The final visual acuity of patients with diabetic vitreous hemorrhage after micro-invasive vitrectomy is related to the CFT,the status of IS/OS junction,whether ME or not,but not related to integrity of the ELM or whether ERM or not. Key words: Diabetic retinopathy/complications; Vitreous hemorrhage/surgery; Tomography,optical coherence