Clinical Ophthalmology (Aug 2016)

The outcomes and prognostic factors of vitrectomy in chronic diabetic traction macular detachment

  • Abunajma MA,
  • Al-Dhibi H,
  • Abboud EB,
  • Al Zahrani Y,
  • Alharthi E,
  • Alkharashi A,
  • Ghazi NG

Journal volume & issue
Vol. Volume 10
pp. 1653 – 1661

Abstract

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Muneera A Abunajma,1 Hassan Al-Dhibi,1 Emad B Abboud,1 Yahya Al Zahrani,1 Essam Alharthi,2 Abdullah Alkharashi,3 Nicola G Ghazi1,4 1Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 2Al Hokama Eye Center, Riyadh, Saudi Arabia; 3Department of Ophthalmology, College of Medicine, King Saud University Riyadh, Saudi Arabia; 4Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA Purpose: To investigate the outcomes of pars plana vitrectomy (PPV) for chronic diabetic traction macular detachment (CTMD).Methods: Ninety-six eyes that underwent PPV for CTMD of at least 6 months duration were retrospectively analyzed. Retinal reattachment rate, final vision, and prognostic factors for poor visual outcome were the main outcome measures.Results: All eyes had long-standing TMD (median 12, range: 6–70 months). The median postoperative follow-up was 15 (range: 3–65) months. Eighty-seven eyes (90.6%) had their retina and macula reattached after one PPV. At final examination, 84 eyes (87.5%) had stable vision or at least one line improvement, and three had no light perception. Seventeen (17.7%) and 41 (43%) eyes had preoperative visual acuity of ≥20/200 and ≥5/200 as compared to 40 (41.6%; P=0.0005) and 64 (66.7%; P=0.0014) eyes at final follow-up, respectively. Age >50 years (Odds ratio [OR] =5.84, 95% confidence interval [CI] =1.53–22.19, P=0.01), preoperative vision <20/400 (OR =7.012, 95% CI =1.82–26.93, P=0.005), and ischemic macula (OR =14.13, 95% CI =3.61–55.33, P<0.001) were significantly associated with final vision <20/400.Conclusion: PPV for CTMD may be beneficial particularly in patients who are relatively younger and have good baseline vision and no macular ischemia. Keywords: chronic diabetic traction macular detachment, diabetic retinopathy, diabetic traction macular detachment, pars plana vitrectomy

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