Vitrectomy for center-involved diabetic macular edema

David J Browning,1 Chong Lee,1 Michael W Stewart,2 Maurice B Landers III3 1Charlotte Eye, Ear, Nose and Throat Associates, Charlotte, NC, 2Mayo Clinic, Jacksonville, FL, 3Kittner Eye Center, University of North Carolina, Chapel Hill, NC, USA Purpose: To determine the effect of vitrectomy for cente...

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Autores principales:	Browning DJ, Lee C, Stewart MW, Landers III MB
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	diabetic macular edema vitrectomy optical coherence tomography ellipsoid zone Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/8654951ce8714674b6c39ff579566775
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spelling	oai:doaj.org-article:8654951ce8714674b6c39ff5795667752021-12-02T05:17:10ZVitrectomy for center-involved diabetic macular edema1177-5483https://doaj.org/article/8654951ce8714674b6c39ff5795667752016-04-01T00:00:00Zhttps://www.dovepress.com/vitrectomy-for-center-involved-diabetic-macular-edema-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483David J Browning,1 Chong Lee,1 Michael W Stewart,2 Maurice B Landers III3 1Charlotte Eye, Ear, Nose and Throat Associates, Charlotte, NC, 2Mayo Clinic, Jacksonville, FL, 3Kittner Eye Center, University of North Carolina, Chapel Hill, NC, USA Purpose: To determine the effect of vitrectomy for center-involved diabetic macular edema (CI-DME). Methods: This was a retrospective study of 53 eyes of 45 patients who had vitrectomy for CI-DME and were followed up for at least 12 months. Charts were reviewed for visual acuity (VA), central subfield mean thickness measured by optical coherence tomography, presurgical and postsurgical interventions for CI-DME, and number of office visits in the first 12 months after surgery. Preoperative spectral domain optical coherence tomography was performed on 38 patients, and they were graded for ellipsoid zone (EZ) intactness by three independent graders with assessment of agreement between graders using intraclass correlation coefficients and Bland–Altman analysis. Results: The median VA improved from 20/100 (interquartile range [IQR], 20/63–20/200) at baseline to 20/63 (IQR, 20/32–20/125) at 12 months. The median central subfield mean thickness improved from 505 µm (IQR, 389–597 µm) at baseline to 279 µm (IQR, 246–339 µm) at 12 months. Intergrader agreement for EZ intactness was moderate (intraclass correlation coefficients 0.4294–0.6356). There was no relationship between preoperative intactness of the EZ and the 12-month change in VA. Conclusion: Vitrectomy consistently thins the macula in CI-DME and, on average, leads to clinically significant improvement in VA comparable in size to that reported with serial intravitreal anti-vascular endothelial growth factor injections. A large, comparative, prospective, randomized clinical trial of these two treatments is needed to determine which is more effective and cost-effective. Keywords: center-involved diabetic macular edema, diabetic macular edema, vitrectomy, spectral domain OCTBrowning DJLee CStewart MWLanders III MBDove Medical Pressarticlediabetic macular edemavitrectomyoptical coherence tomographyellipsoid zoneOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2016, Iss Issue 1, Pp 735-742 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetic macular edema vitrectomy optical coherence tomography ellipsoid zone Ophthalmology RE1-994
spellingShingle	diabetic macular edema vitrectomy optical coherence tomography ellipsoid zone Ophthalmology RE1-994 Browning DJ Lee C Stewart MW Landers III MB Vitrectomy for center-involved diabetic macular edema
description	David J Browning,1 Chong Lee,1 Michael W Stewart,2 Maurice B Landers III3 1Charlotte Eye, Ear, Nose and Throat Associates, Charlotte, NC, 2Mayo Clinic, Jacksonville, FL, 3Kittner Eye Center, University of North Carolina, Chapel Hill, NC, USA Purpose: To determine the effect of vitrectomy for center-involved diabetic macular edema (CI-DME). Methods: This was a retrospective study of 53 eyes of 45 patients who had vitrectomy for CI-DME and were followed up for at least 12 months. Charts were reviewed for visual acuity (VA), central subfield mean thickness measured by optical coherence tomography, presurgical and postsurgical interventions for CI-DME, and number of office visits in the first 12 months after surgery. Preoperative spectral domain optical coherence tomography was performed on 38 patients, and they were graded for ellipsoid zone (EZ) intactness by three independent graders with assessment of agreement between graders using intraclass correlation coefficients and Bland–Altman analysis. Results: The median VA improved from 20/100 (interquartile range [IQR], 20/63–20/200) at baseline to 20/63 (IQR, 20/32–20/125) at 12 months. The median central subfield mean thickness improved from 505 µm (IQR, 389–597 µm) at baseline to 279 µm (IQR, 246–339 µm) at 12 months. Intergrader agreement for EZ intactness was moderate (intraclass correlation coefficients 0.4294–0.6356). There was no relationship between preoperative intactness of the EZ and the 12-month change in VA. Conclusion: Vitrectomy consistently thins the macula in CI-DME and, on average, leads to clinically significant improvement in VA comparable in size to that reported with serial intravitreal anti-vascular endothelial growth factor injections. A large, comparative, prospective, randomized clinical trial of these two treatments is needed to determine which is more effective and cost-effective. Keywords: center-involved diabetic macular edema, diabetic macular edema, vitrectomy, spectral domain OCT
format	article
author	Browning DJ Lee C Stewart MW Landers III MB
author_facet	Browning DJ Lee C Stewart MW Landers III MB
author_sort	Browning DJ
title	Vitrectomy for center-involved diabetic macular edema
title_short	Vitrectomy for center-involved diabetic macular edema
title_full	Vitrectomy for center-involved diabetic macular edema
title_fullStr	Vitrectomy for center-involved diabetic macular edema
title_full_unstemmed	Vitrectomy for center-involved diabetic macular edema
title_sort	vitrectomy for center-involved diabetic macular edema
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/8654951ce8714674b6c39ff579566775
work_keys_str_mv	AT browningdj vitrectomyforcenterinvolveddiabeticmacularedema AT leec vitrectomyforcenterinvolveddiabeticmacularedema AT stewartmw vitrectomyforcenterinvolveddiabeticmacularedema AT landersiiimb vitrectomyforcenterinvolveddiabeticmacularedema
_version_	1718400481028472832

Vitrectomy for center-involved diabetic macular edema

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