Optical coherence tomography assessment of the vitreoretinal relationship in diabetic macular edema

PURPOSE: To study the vitreoretinal relationship in diabetic patients with and without diabetic macular edema (DME) using optical coherence tomography. DESIGN: Retrospective case-control study. METHODS: SETTING: Institutional practice. PATIENTS: Thirty,five consecutive diabetic patients (49 eyes) with DME and 35 sex, and age-matched diabetic control patients without DME (49 eyes). OBSERVATION PROCEDURE: All patients had Early Treatment Diabetic Retinopathy Study visual acuity measurement and biomicroscopic examination of the vitreoretinal intern face. OCT was performed to obtain cross-sectional images of the vitreoretinal interface of the macular region. Posterior vitreous detachment (PVD) was staged from 0 to 3 as follows: stage 0: absence of PVD; stage 1: perifoveolar PVD with foveolar attachment; stage 2: incomplete PVD with residual attachment to the optic nerve; and stage 3: complete PVD. Retinal thickness was measured using OCT mapping software in all cases. MAIN OUTCOME MEASURES: Prevalence of the different PVD stages in both groups of eyes. RESULTS: The mean age of the patients was 60 years in both groups. Of the eyes with macular edema, 19 (38.8%) were stage 0, 26 (53.0%) stage 1, 1 (2.0%) was stage 2, and 3 (6.2%) were stage 3. In eyes without DME, the corresponding figures were, respectively, 34 (69.4%), 11 (22.4%), 1 (2.0%), and 3 (6.2%). The prevalence of perifoveolar PVD with foveolar attachment was significantly higher in the group of eyes with DME (P = .006). CONCLUSIONS: These results show the high prevalence of perifoveolar PVD with foveolar attachment in diabetic patients with macular edema. Even though PVD is not the main factor involved in the pathogenesis of DME, perifoveolar PVD may have a role in the development of this complication. (c) 2005 by Elsevier Inc. All rights reserved.