Microperimetry, chromatic macular visual field testing and mfERG testing revealed an abnormal retinal response with an unstable eccentric foveocentral fixation pattern and a profound reduction in the N1- and P1-wave nV amplitudes with a prolonged P1 implicit time.Ĭonclusion: Despite successful anatomical reattachment of the macula, long-term postoperative microcirculatory abnormalities along with persistent and ischemic tissue were detected predominantly in the recurrent TRD group due to multiple microcirculatory defects, including ischemic edema of the external and internal layers of the retina and DRIL. Longitudinal multimodal imaging tests demonstrated abnormal superficial and deep microcirculation patterns with multiple micro-abnormalities of the foveal avascular zone and different but distinct areas of non-perfused macula on OCT angiography, as well as the presence of disorganization of the retinal inner layers (DRIL) and chronic ischemic macular edema in 82% of the eyes examined by SD-OCT. The mean time for macular detachment resolution was 3.6 ± 1.7 weeks in the group showing pure macular tractional detachment and 1.8 ± 0.8 weeks in the group showing combined tractional and rhegmatogenous macular detachment (p < 0.05) for the eye group with one surgery only and 12.2 ± 8.1 weeks SD for the eyes with more than one surgery (p < 0.05). The mean duration of vision loss before surgery was 11.6 ± 2.3 weeks SD. Results: The mean difference between the pre-, 3 months and final postoperative BCVA was significant (p < 0.05). The secondary outcomes were correlating the long-term final postoperative BCVA with the multimodal, serial postoperative multimodal evaluation. Main outcome measures: The primary outcomes were to analized the perfusional, structural and functional postoperative findings of the intentionally selected eyes with a fully resolved diabetic TRD that underwent timely sophisticated pars plana vitrectomy (PPV) techniques. Structural, perfused and functional postoperative findings were statistical analized. Methods: All patients underwent pars plana vitrectomy and successfully surgical resolution of tractional retinal detachment forming only one surgery group and more than one surgery group in cases of recurrent diabetic TRD. Participants: 30 selected eyes of 26 patients (out of 256 eyes of 124 consecutive patients) with a mean diabetes evolution period of 18.4 ± 4.8 years SD who underwent successful vitrectomy techniques for tractional retinal detachment involving the macula, between January 2016 and December 2020. Purpose: To report the anatomic and functional outcomes in diabetic macula-off tractional retinal detachment.ĭesign: Multicenter, retrospective, interventional, consecutive case series. - Ethics approval and consent to participate.- Structural and multimodal functional results.- Results of comparing chromatic campimetry testing findings for postoperative BCVA.- Results of comparing mfERG findings for postoperative BCVA.- Results of comparing OCT angiography findings for postoperative BCVA.- Results of correlation of BCVA at three months postoperative and final postoperative evaluation for eyes with recurrent TRD and eyes with one surgical procedure.- Surgical effect on compared BCVA and CSFT.
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