Evaluation of Vitrectomy with Planned Foveal Detachment as Surgical Treatment for Refractory Diabetic Macular Edema with or without Vitreomacular Interface Abnormality

Figure 1

(a) Preoperative color fundus photo and FA showing diffuse DME with foveal hard exudate accumulation, CMT by OCT measuring 537 microns after 9 IVB injections over 1 year, BCVA measuring 0.1. (b) OCT after 3 IV triamcinolone (TA) injections 3 months apart with CMT measuring 565 microns and no improvement in BCVA. (c) Upper photo showing ILM peeling after dual stain application, while lower phot showing submacular BSS injection. (d) Red free showing significant decrease in amount of hard exudates 1 month postoperation, with drop of CMT to 297 microns and BCVA improvement to 0.3. Middle OCT with the thickness map showing recurrence of DME measuring 333 microns 6 months postoperation. The right-hand side OCT image and thickness map after 2 IVTA injections 2 months apart with slight CMT improvement of 327 microns while regaining a BCVA of 0.3 which was measured 10 months postoperation.

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