Authors
Martynov A.O., Fajzrahmanov R.R., SHishkin M.M., Pavlovskij O.A., Kalinin M.E.
Pirogov National Medical and Surgical Center, Moscow
Abstract
Target. To evaluate changes in retinal thickness according to optical coherence tomography (OCT) in patients with resistant diabetic macular edema after vitreoretinal surgery.
Materials and methods. 30 patients (30 eyes) with a diagnosis of resistant diabetic macular edema were examined. In group 1 (15 patients, 15 eyes), a standard 25G vitrectomy with membrane peeling was performed. In group 2, 15 people (15 eyes) underwent 25G vitrectomy, membrane peeling, and subretinal administration of a balanced saline solution.
Results. A week after the operation, patients in the 2nd group showed a decrease in the total thickness of the retina (Full retinal) compared to the 1st group, according to OCT. The average value was 334.1± 23.7 microns (p = 0.047), which was 1.17 times less than in patients of the 1st group. By the end of the first month, the thickness of the retina decreased to 280.7±24.1 microns (p = 0.045 compared with patients in group 1), which corresponded to a decrease of 1.25 times.
There was also a statistically significant decrease in retinal thickness in the para- and perifoveal regions, mainly in the temporal sector. In the upper sector, the dynamics was less pronounced and manifested itself later, for periods from 1 to 6 months of follow-up.
In the Inner/Outer Retinal Thick modes, it was revealed that a significant change in retinal thickness occurs due to a decrease in the outer layer.
Conclusion. The use of vitrectomy with peeling and subretinal administration of balanced saline solution in refractory diabetic macular edema contributed to a decrease in retinal thickness according to OCT. The results obtained indicate the effectiveness and potential of this surgical technique in the treatment of resistant forms of diabetic macular edema (DMO) that do not respond to standard Anti-VEGF and steroid therapy.
Keywords: vitrectomy, diabetic macular edema, balanced saline solution, submacular surgery, optical coherence tomography.
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