Structural and Perfusional Study of Successfully Repaired Diabetic Tractional Retinal Detachment Involving the Macula

摘要

Purpose: Severe visual sequelae can be frequently observed in patients with diabetic tractional retinal detachment (TRD) involving the macula. We analyzed the postoperative structural spectral-domain (SD)-OCT and optical coherent tomography angiography (OCT angiography) findings in four selected eyes that were enrolled after successful anatomical diabetic macular detachment repair. These diabetic macular tractional detachments were evolved within 16 weeks. We also correlated the postoperative mean best-corrected visual acuity with the postoperative SD-OCT and OCT angiographic findings. Methods: This case series included 4 selected eyes of 4 patients with a mean diabetes evolution period of 18.44.8 years SD. Vitrectomy techniques were successfully used for TRD involving the macula. Postoperative SD-OCT, and final postoperative functional evaluations, including BCVA and OCT angiographic evaluation were performed at the final postoperative follow-up visit. Results: The mean difference between the preoperative (0.870.15) and final postoperative (0.350.21) BCVA was significant (p0.05). The mean duration of vision loss before surgery was 11.62.3 weeks. The mean time for postoperative macular detachment resolution was 3.61.7 weeks SD. A mean follow-up evaluation of 13.12.7 SD months. Final postoperative imaging tests demonstrated multiple abnormalities of the foveal avascular zone and different areas of non-perfused macula on OCT angiography. The presence of disorganization of the retinal inner layers (DRIL) and chronic ischemic macular edema changes in 3 eyes (75.0%) as well as the OCT angiography abnormal findings in 3 (75.0%) were analized and correlated. Conclusion: In successfully reattached macula, postoperative microcirculatory abnormalities consistent with superficial and deep plexuses deficiencies and vessel densities alterations were detected as well as persistent DRIL, EZ and ELM line abnormalities.