title: Prevalence of vitreomacular interface abnormalities on spectral domain optical coherence tomography of patients undergoing macular photocoagulation for centre involving diabetic macular oedema.
abstract: OBJECTIVE
  Macular traction may influence the formation and response to treatment of diabetic macular oedema (DME). The aim of this study was to determine the prevalence and associations of spectral domain optical coherence tomography (SD-OCT) evident epiretinal membrane (ERM) and/or partial vitreomacular separation (pVMS) in consecutive patients undergoing macular photocoagulation for centre involving DME.
  
  
  METHODS
  A single-centre retrospective cross-sectional observational study.
  
  
  RESULTS
  198 eyes of 198 patients were included. Twelve per cent of eyes demonstrated pVMS and 14% ERM. All cases of pVMS had vitreoretinal adhesion located in the Early Treatment Diabetic Retinopathy Study grid central 1 mm subfield. In 2/3 of ERM cases, ERM was either found in the central subfield or the thickening associated with ERM was contiguous with the thickening in the central subfield. Patients with signs of ERM or pVMS were significantly older and had significantly worse acuity than those without (mean age 67.2 vs 62.8 years (p=0.02); 0.49 vs 0.31 logMAR, p=0.0006). Macular thickness was similar in both groups. The prevalence of pVMS and/or ERM were 31% in Caucasian, 5% in Asian and 24% in Afro-Caribbean subjects (p=0.11).
  
  
  CONCLUSIONS
  ERM or pVMS was found on SD-OCT scanning in 25% of patients undergoing laser for centre involving DME. In 20% of all patients, these potentially tractional elements were either present in the central subfield scan or the traction was contiguous with the central macular thickening, suggesting a possible role for surgical or enzymatic relief of traction in their management. This requires targeted investigation.
authors: Guy's Kings' Thomas' Medical School, University of London, London, UK.
authors: I
authors: I
authors: Akbar Khan
authors: Department of Ophthalmology, St Thomas' Hospital, Guys & St Thomas' Hospital NHS Foundation Trust, London, UK.
authors: M D
authors: MD
authors: Mohamed
authors: Department of Ophthalmology, St Thomas' Hospital, Guys & St Thomas' Hospital NHS Foundation Trust, London, UK.
authors: S S
authors: SS
authors: Mann
authors: Department of Ophthalmology, St Thomas' Hospital, Guys & St Thomas' Hospital NHS Foundation Trust, London, UK.
authors: P G
authors: PG
authors: Hysi
authors: Department of Ophthalmology, St Thomas' Hospital, Guys & St Thomas' Hospital NHS Foundation Trust, London, UK.
authors: D A
authors: DA
authors: Laidlaw
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000601:surgery*; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000453:epidemiology*; D005128:Eye Diseases / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D017075:Laser Coagulation; D008269:Macular Edema / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D000267:Tissue Adhesions; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000473:pathology*
keywords: Diagnostic tests/Investigation; Imaging; Macula; Treatment Surgery; Vitreous