Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Treatment-Naïve Diabetic Macular Edema: A Prospective, Uncontrolled Pilot Study

Ryan B Rush, Sloan W Rush, Ryan B Rush, Sloan W Rush

Abstract

Purpose: To report the outcomes in subjects undergoing pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for the management of treatment-naïve diabetic macular edema (DME).

Methods: Ten treatment-naïve subjects with non-proliferative diabetic retinopathy prospectively underwent PPV with ILM peeling for the treatment of DME at a single university-affiliated institution. The preoperative features, intraoperative details and postoperative outcomes were collected and analyzed.

Results: All 10 subjects underwent PPV with ILM peeling without significant intraoperative or postoperative complications at 6 months follow-up. Visual acuity improved from a baseline of 0.74 (95% CI: 0.48-1.0) logMAR (Snellen 20/110) to 0.46 (95% CI: 0.3-0.62) logMAR (Snellen 20/58) at 6 months follow-up (p=0.045). Optical coherence tomography central macular thickness reduced from a baseline of 456 (95% CI: 394.7-516.4) microns to 316.8 (95% CI: 275.9-357.7) microns at 6 months follow-up (p < 0.001).

Conclusion: This pilot study suggests that PPV with ILM peeling may be a viable treatment option for the management of treatment naïve DME in subjects with non-proliferative diabetic retinopathy. Development of a randomized controlled trial may be justified to validate the results of this study.

Clinicaltrialsgov identifier #: NCT03660345.

Keywords: diabetic macular edema; internal limiting membrane peeling; vitrectomy.

Conflict of interest statement

The authors report no conflicts of interest in this work.

© 2021 Rush and Rush.

Figures

Figure 1
Figure 1
A 68-year female with severe non-proliferative diabetic retinopathy presented with treatment-naïve diabetic macular edema with subjective vision loss for 9 months. (A) The preoperative (baseline) optical coherence tomography image displays substantial diabetic macular edema with a central macular thickness of 521 microns. The patient’s Snellen visual acuity was 20/125. (B) The 6-month postoperative optical coherence tomography image demonstrates resolution of the diabetic macular edema with a central macular thickness reduction to 245 microns following vitrectomy with internal limiting membrane peeling. The Snellen visual acuity improved to 20/50.

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Source: PubMed

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