Is immediate treatment necessary for diabetic macular edema after pars plana vitrectomy for tractional complications of proliferative diabetic retinopathy?
Is immediate treatment necessary for diabetic macular edema after pars plana vitrectomy for tractional complications of proliferative diabetic retinopathy?
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DOI：
10.1007/s10792-021-01923-w
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发表时间：
2021-06-25
影响因子：
1.6
通讯作者：
Panchal, Bhavik
中科院分区：
文献类型：
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作者：
Behera, Umesh Chandra;Das, Taraprasad;Panchal, Bhavik
目的评价玻璃体切除术后糖尿病性黄斑水肿（DME）对增殖性糖尿病视网膜病变（PDR）牵引性并发症的治疗效果。方法在印度进行的一项回顾性多中心观察性研究中，对2型糖尿病患者玻璃体切除眼伴中心累及DME的牵引性PDR并发症的临床结果进行了至少12个月的随访。比较接受治疗者和观察者的DME状态和视力结果。结果在10年的研究期间，来自印度5个三级中心的44例患者的45只眼睛符合纳入标准。在pars计划玻璃体切除术（PPV）治疗PDR牵引性并发症平均7 +/- 7个月后，记录了涉及中心的DME。超过一半（n = 25）的眼睛立即接受了DME治疗，其余的则推迟治疗。1年后，治疗组（467.9 +/- 124.8 mu m）、观察组（405.2 +/- 132.6 mu m）、观察组（325.6 +/- 149 mu m）的平均中心子野厚度均有统计学意义（p < 0.001），变化具有可比性（p = 0.574）。视力的变化也具有可比性（治疗组和观察组的Log MAR分别为0.12 +/- 0.31和0.22 +/- 0.54;p = 0.443）。结论：对于PPV治疗PDR牵引性并发症后已存在或新发DME的治疗可推迟至一年，因为DME可能随时间自行消退。
Purpose To assess the treatment benefit of eyes with diabetic macular edema (DME) in vitrectomized eyes for tractional complications of proliferative diabetic retinopathy (PDR). Methods In a retrospective multicentre observational study in India, the clinical outcomes of eyes with center-involving DME in vitrectomized eyes for tractional complications of PDR in people with type 2 diabetes with at least 12 months follow-up data were assessed. The DME status and visual acuity outcomes were compared between those who received treatment versus those observed. Results In the 10-year study period, 45 eyes of 44 patients from 5 tertiary centers in India met the inclusion criteria. Center-involving DME was documented after a mean of 7 +/- 7 months following pars plan vitrectomy (PPV) for tractional complications of PDR. More than half of the (n = 25) eyes were immediately treated for DME, and treatment was deferred for the rest. At one year, there was a statistically significant reduction in mean central subfield thickness in treated (467.9 +/- 124.8 mu m to 367.8 +/- 143.7 mu m; p < 0.001) as well as observed (405.2 +/- 132.6 mu m to 325.6 +/- 149 mu m; p < 0.001) eyes, and the change was comparable (p = 0.574). The change in vision was also comparable (0.12 +/- 0.31 and 0.22 +/- 0.54 Log MAR in the treated and observed group, respectively; p = 0.443). Conclusion Treatment for pre-existing or new-onset DME after PPV for tractional complications of PDR may be deferred for up to one year because the DME may resolve spontaneously with time.