title: Spectral domain ocular coherence tomography findings pre- and post vitrectomy with fibrovascular membrane delamination for proliferative diabetic retinopathy.
abstract: PurposeTo describe the intraretinal microstructure using serial spectral domain optical coherence tomography (SD-OCT) preceding and following pars plana vitrectomy and delamination of fibrovascular membranes in patients with proliferative diabetic retinopathy (PDR).MethodsThis retrospective, interventional case series includes 28 eyes. Outcome measures included LogMAR distance best-corrected visual acuity (BCVA), SD-OCT integrity of photoreceptor inner and outer segments junction (IS/OS), and integrity of external limiting membrane (ELM).ResultsPre-operative central macular thickness (CMT) was significantly correlated with the final post-operative LogMAR BCVA (Pearson's coefficient r=0.89; P=0.001). The eyes were categorised into three groups based on post-operative IS/OS integrity (group 0: IS/OS intact; group 1: IS/OS irregular but not completely disrupted; group 2: IS/OS completely disrupted). Mean BCVA improved significantly in group 0 (n=9) from 1.13±0.75 preoperatively to 0.34±0.21 (Student's t-test: P=0.06), in group 1 (n=10) the BCVA improved from 0.88±0.56 to 0.58±0.31 (Student's t-test: P=0.053) and in group 2 (n=9) the BCVA improved from 1.64±0.53 to 1.53±0.75 (Student's t-test: P=0.652).IS/OS integrity and ELM integrity at 3 months post operatively, were significantly and positively correlated with final BCVA (Pearson's coefficient: r=0.83, P<0.001 and r=0.72, P<0.001, respectively).ConclusionsPre-operative CMT and post-operative disruption of the IS/OS and ELM are useful prognostic indicators in fibrovascular delamination surgery for patients with PDR.
authors.affiliation: Barts Health; Whipps Cross University Hospital, London, UK.
authors.forename: I
authors.identifier: http://orcid.org/0000-0003-0980-2037
authors.initials: I
authors.lastname: Dooley
authors.affiliation: Barts Health; Whipps Cross University Hospital, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Laviers
authors.affiliation: Barts Health; Whipps Cross University Hospital, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Papavasileiou
authors.affiliation: Barts Health; Whipps Cross University Hospital, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Mckechnie
authors.affiliation: Barts Health; Whipps Cross University Hospital, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Zambarakji
mesh_terms: D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000473:pathology*; D003930:Diabetic Retinopathy / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011184:Postoperative Period; D057234:Preoperative Period; D055211:Retinal Photoreceptor Cell Inner Segment / Q000473:pathology*; D055214:Retinal Photoreceptor Cell Outer Segment / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy