title: The effectiveness of vitrectomy for diffuse diabetic macular edema may depend on its preoperative optical coherence tomography pattern.
abstract: BACKGROUND
  To investigate the effectiveness of vitrectomy for diffuse diabetic macular edema (DDME) and its dependence on optical coherence tomography (OCT) findings.
  
  
  METHODS
  The records of 65 patients and 81 eyes who received vitrectomy for DDME and followed up for at least 6 months were retrospectively reviewed. All eyes were classified according to their morphological characteristics on OCT including sponge-like diffuse retinal thickening (SDRT: n = 13), cystoid macular edema (CME: n = 42), serous retinal detachment (SRD: n = 13), and the combination of all morphological characteristics (FULL: n = 13). The best-corrected visual acuity (BCVA) and spectral domain OCT were investigated preoperatively and at 1, 3, and 6 months postoperatively.
  
  
  RESULTS
  At six months after surgery, BCVA in logMAR units was significantly improved in all groups except the SDRT group. The improvement was -0.04 ± 0.20 in the SDRT group (P = 0.504), -0.16 ± 0.24 in the CME group (P < 0.01), -0.32 ± 0.32 in the SRD group (P < 0.01), and -0.26 ± 0.19 in the FULL group (P < 0.01), and significantly better in eyes with subretinal fluid (SRF; the SRD and FULL groups) than in eyes without SRF (the SDRT and CME groups, P = 0.003).
  
  
  CONCLUSIONS
  Vitrectomy can be a useful treatment option for DDME, particularly for eyes with SRF.
authors.affiliation: Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan. ichiyama@belle.shiga-med.ac.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ichiyama
authors.affiliation: Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Sawada
authors.affiliation: Soseikai General Hospital, Kyoto, 612-8473, Japan.
authors.forename: Takamasa
authors.initials: T
authors.lastname: Mori
authors.affiliation: Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Fujikawa
authors.affiliation: Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Kawamura
authors.affiliation: Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Ohji
mesh_terms: D000368:Aged; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008266:Macula Lutea / Q000000981:diagnostic imaging* / Q000601:surgery; D008269:Macular Edema / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity; D014821:Vitrectomy
keywords: Classification; Diabetic macular edema; Optical coherence tomography; Pattern; Subretinal fluid; Vitrectomy