Vitreous traction and epiretinal membranes in diabetic macular oedema using spectral-domain optical coherence tomography

Purpose The purpose of this study was to present an association between diabetic macular oedema (DME) and vitreoretinal interface abnormalities using 3D spectral domain optical coherence tomography (SD-OCT). Methods In a retrospective study, charts and SD-OCT of consecutive patients with diffuse or focal DME were reviewed. Only one randomly chosen eye per patient with DME was included, and eyes that had another retinopathy that could affect the study analysis or that underwent vitreoretinal surgery were excluded. Results Out of 58 eyes (58 patients) with DME, 11 eyes (19.0%) had vitreofoveal traction (Group A), either unifocally (n = 6) or multifocally; that is, associated with additional extrafoveal traction site(s). Group B comprised 20 eyes (34.5%) that had sole extrafoveal vitreous traction, at either retinal and/or papillary sites. In each, the retinal oedema underlying extrafoveal traction was in continuum in at least one site with that at the central macula, as verified by the macular maps, thus presented as diffuse macular oedema. In Group C, 13 eyes (22.4%) had an epiretinal membrane (ERM), 1.5 x 3 mm to >= 6 x 6 mm in size that overlaid diffuse oedematous macula. Group D included 14 eyes (24.1%) that had neither vitreous traction nor ERM; 12 (20.7%) of them had DME secondary to leaking microaneurysms with or without leaking capillary beds, and the remaining two had leakage from non-microaneurysms sources. Conclusions DME was detected by the SD-OCT to be associated with sole extrafoveal vitreous traction in one-third of the patients. Further studies are required to evaluate the clinical consequences of these observations. Eye (2010) 24, 1545-1553; doi:10.1038/eye.2010.80; published online 4 June 2010