Atsushi Fujiwara
   Department   Kawasaki University of Medical Welfare  ,
   Position   Assistant Professor
Article types 原著
Language English
Peer review Peer reviewed
Title Planned foveal detachment technique for the resolution of diffuse diabetic macular edema.
Journal Formal name：Japanese journal of ophthalmology
Abbreviation：Jpn J Ophthalmol
ISSN code：16132246/00215155
Domestic / ForeginForegin
Volume, Issue, Page 59(5),pp.279-287
Author and coauthor Morizane Yuki, Kimura Shuhei, Hosokawa Mio, Shiode Yusuke, Hirano Masayuki, Doi Shinichiro, Hosogi Mika, Fujiwara Atsushi, Inoue Yasushi, Shiraga Fumio
Publication date 2015/09
Summary PURPOSE:To evaluate the therapeutic efficacy of a novel surgical procedure for diffuse diabetic macular edema (DME), performed in conjunction with conventional vitrectomy.METHODS:This prospective, interventional case series involved 20 eyes of 18 consecutive DME patients with best-corrected visual acuities (BCVAs) between 0.301 and 1.221 logarithm of the minimal angle of resolution (logMAR) units and central retinal thicknesses (CRTs) greater than 275 μm. After vitrectomy, a small retinal detachment was made in the macula by injecting 50-100 μl balanced salt solution into the subretinal space using a 38-gauge needle. Before finishing the surgery, fluid-air exchange was performed. Patients were asked to remain in prone position for 1 day postoperatively. The main outcome measures were CRT and BCVA.RESULTS:The mean CRT of 554.6 ± 152.7 μm before surgery significantly decreased to 295.6 ± 92.5 μm (p < 0.0001) 1 week after surgery and to 185.8 ± 67.4 μm (p < 0.0001) at 6 months after surgery. The CRT was less than 250 μm in 18 eyes (90 %) at 6 months after surgery. The mean BCVA before surgery (0.706 ± 0.348) significantly improved at 6 months after surgery (0.431 ± 0.392, p < 0.0001). Postoperative BCVAs improved by more than 0.3 logMAR units in 13 eyes (65 %), remained unchanged in six eyes (30 %) and worsened in one eye (5 %). Macular edema recurred in three eyes (15 %) 2 months after surgery.CONCLUSIONS:This novel planned foveal detachment technique facilitated a rapid resolution of DME and contributed to improved visual acuity.
DOI 10.1007/s10384-015-0390-4
PMID 26220819