![]() Like a taut posterior hyaloid or VMT, an epiretinal membrane (ERM) can also exert traction on the retina and contribute to DME. Taken together, these three studies suggest that DME may improve in patients with an attached hyaloid, even without known traction. found resolution of macular edema in all patients after a median period of 3 months and improvement of VA (median improvement of five lines) after vitrectomy in 21 eyes with DME with an attached hyaloid but no known traction. The best corrected visual acuity (BCVA) improved by more than two lines in 38 % of eyes and remained the same in 54 %. ![]() At 6 months postoperatively, the mean foveal thickness decreased significantly from 630 to 350 μm. subsequently evaluated 13 DME eyes with retinal swelling on OCT before and after vitrectomy. The diffuse macular edema had resolved within 2 weeks and VA was maintained or improved. The cystoid changes had disappeared by 5 days postoperatively in all eyes. described three DME eyes without clinical evidence of traction in the pre-OCT era that underwent vitrectomy. In addition to cases with a taut posterior hyaloid or VMT, there is also support in the literature for vitrectomy in some patients with an attached hyaloid but no observable traction. Taken together, these results suggest that vitrectomy with posterior hyaloid elevation and removal can be beneficial in the setting of DME with VMT. Finally, surgical interventions were not standardized. There was no control group, and VMT was defined by clinical judgment rather than a standardized definition. Based on this study, vitrectomy for DME associated with VMT appears beneficial however, the study has several shortcomings. After separation of vitreofoveal traction, improvement of macular edema was detected on OCT (Fig. VA improved by ≥10 letters in 38 % of eyes but deteriorated by ≥10 letters in 22 % of eyes. At 6 months postoperatively, median OCT thickness decreased by 160 μm and 68 % of eyes had ≥50 % reduction in macular thickness. Membrane peel (ERM) was performed in 61 % and ILM peeling in 54 % of cases. Surgical intervention beyond vitrectomy was not standardized. The study included 87 eyes with VMT based on the “investigator’s evaluation,” baseline VA 20/63 to 20/400, and OCT central subfield thickness >300 μm. The Diabetic Retinopathy Clinical Research Network (DRCRnet) Vitrectomy Study was a large prospective study that examined vitrectomy for DME in eyes with at least moderate vision loss and VMT.
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