First Author: S.Talibova AZERBAIJAN
Co Author(s): M. Shishkin
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Surgical treatment of the tractional form of DME does not always lead to an improvement of functional outcomes. The aim of our work is to identify the relations between postoperative best corrected visual acuity (BCVA) and the condition of the foveal zone in patients undergoing pars plana vitrectomy (PPV) with the peeling of the internal limiting membrane (ILM) for the tractional form of DME.
MedEra Hospital, Baku, Azerbaijan
Retrospectively were examined 16 eyes with tractional form of DME, who underwent PPV with removal of ILPM. The age of patients ranged from 45-65 years. The level of glycosylated haemoglobin was in the range of 6.5-7.5%. Patients were assessed for BCVA, central foveolar zone thickness (CTF) on optical coherence tomography (OCT) and assessed the condition of the macular zone on OCT images at 3, 6, 12 months postoperatively. Patients were divided into 2 groups depending on the postoperative visual acuity. In the first group (9 eyes), BCVA from 0.05 ± 0.01 in the preoperative period changed to 0.08 ± 0.02 in 3 months, remained at this level on the 6th and 12th months. In the 2nd group (7 eyes), BCVA from 0.08 ± 0.04 in the preoperative period increased to 0.25 ± 0.02 in 3 months, to 0.45 ± 0.05 at the 6th month and remained at this level until the 12th month
CTF in both groups with 380 ± 25μ preoperatively decreased to 230 ± 15μ in 3 months, up to 200 ± 15μ in 6 months and remained at this level until the 12th month. OCT images of patients in each group were also analyzed. The images were evaluated by the absence of the foveal pit and the diffuse thickening of the macular zone. In the 1st group, in 4 patients (44.5%) there was no foveal depression in the OCT image, in 3 eyes (33.3%) there was diffuse thickening of the macular zone together with loss of the foveal fossa, and 2 eyes (22.2%) had a diffuse thickening of the macular zone. All these pathological changes persisted up to 12 months of the postoperative period. In the second group, there were no pathological changes in the macular area and the foveal pit was preserved. Then, despite the equal decreasing of CTF in both groups, the visual acuity differs significantly between groups.
Thus, the anatomical preservation of the macular zone plays a more important role in the functional outcome at the postoperative period, than the thickness of the central zone of the retina. Study founds that the macular profile significantly associated with visual acuity.