Factors Associated With Visual Acuity Outcomes After Vitrectomy for Diabetic Macular Edema

Abstract

Purpose: To evaluate factors associated with favorable outcomes after vitrectomy for diabetic macular edema (DME). Methods: Data were collected prospectively on 241 eyes undergoing vitrectomy for DME. Multivariate models were used to evaluate associations of 20 preoperative and intraoperative factors with 6-month outcomes of visual acuity and retinal thickness. Results: Median central subfield thickness decreased from 412 μm to 278 μm at 6 months, but median visual acuity remained unchanged (20/80, Snellen equivalent). Greater visual acuity improvement occurred in eyes with worse baseline acuity (P<0.001) and in eyes in which an epiretinal membrane was removed (P = 0.006). Greater reduction in central subfield thickness occurred with worse baseline visual acuity (P<0.001), greater preoperative retinal thickness (P = 0.001), removal of internal limiting membrane (P = 0.003), and with optical coherence tomography evidence of vitreoretinal abnormalities (P = 0.006). No associations with clinician’s preoperative assessments of the posterior vitreous were identified. Conclusion: These results suggest that removal of epiretinal membranes may favorably affect visual outcome after vitrectomy. Pre-operative presence of vitreoretinal abnormalities appeared to be associated with somewhat greater reductions in retinal thickness but not with visual acuity outcome. These results may be useful for future studies evaluating vitrectomy for DME.