Biomarkers and predictors for functional and anatomic outcomes for small gauge pars plana vitrectomy and peeling of the internal limiting membrane in naïve diabetic macular edema: The VITAL Study

• DOI: 10.1371/journal.pone.0200365
• Publication Date: 2018-07-11T14:03:43Z
• Authors: Matias Iglicki; Alejandro Lavaque; Malgorzata Ozimek; Hermino Pablo Negri; Mali Okada; Jay Chhablani; Catharina Busch; Anat Loewenstein; Dinah Zur
• Keywords: Diabetic macular edema

Purpose We aimed to investigate biomarkers and predictive factors for visual anatomical outcome in patients with naïve diabetic macular edema (DME) who underwent small gauge pars plana vitrectomy (PPV) internal limiting membrane (ILM) peeling as a first line treatment. Design Multicenter, retrospective, interventional study. Participants 120 eyes from DME treated PPV ILM follow up of 24 months. Methods Change baseline best corrected acuity (BCVA) central subfoveal thickness (CST) 1, 6, 12 months after surgery. Predictive value BCVA, CST, optical coherence tomography (OCT) features (presence subretinal fluid (SRF) photoreceptor damage), time between diagnosis Additional treatment needed. Intra- post-operative complications (cataract rate formation, increased intraocular pressure). Main measures The correlation characteristics BCVA response (mean change baseline; categorized improvement ≥5 or ≥10; Early Treatment Diabetic Retinopathy Study (ETDRS) letters) Results Mean was 0.66 ± 0.14 logMAR, 0.52 0.21 0.53 logMAR (p<0.001) at baseline, months, respectively. Shorter until (OR: 0.98, 95% CI: 0.97–0.99, p<0.001) predictor good functional (area under the curve 0.828). For every day is postponed, patient's chances gain letters decrease by 1.8%. Presence SRF identified an better outcome, 6.29, 1.16–34.08, p = 0.033). Safety profile acceptable. Conclusions Our results reveal significant primary PPV, without need additional surgical intervention presence predict outcome. These should be considered when chosen.