• History of PPV • Combined rhegmatogenous retinal detachment • Neovascular glaucoma after PPV • Silicone oil in the vitreous cavity longer than 6 months • Who cannot have OCT examination before and after PPV • Patients who had PPV due to PDR and who had OCT examination before and after PPV Clinical Characteristics of the Patients at Baseline (n=60) Age (years, mean ± SD) 52.4 ± 11.6 Sex (male : female) 30 : 26 Eye (od : os) 28 : 32 Pre-operative BCVA (logMAR, mean ± SD) 1.10 ± 0.83 PRP status before PPV (none : partial : full) 8 : 3 : 49 Lens status before PPV (phakic : pseudophakic) 50 : 10 Changes in Macular Appearance in OCT after Diabetic Vitrectomy Jae Pil Shin, M.D. 1 , Woo Hyuk Chang, M.D. 2 , Si Dong Kim, M.D. 3 , Si Yeol Kim, M.D. 4 1 Department of Ophthalmology, Kyungpook National University Hospital, 2 Department of Ophthalmology, Youngnam University Hospital 3 Department of Ophthalmology, Daegu Catholic Hospital, 4 Nune Eye Hospital, Daegu, Korea To classify the structural change of macula with optical coherence tomography (OCT) and to analyze visual prognosis according to the appearance of macula in OCT after pars plana vitrectomy (PPV) in proliferative diabetic retinopathy (PDR) Results Conclusions Exclusion criteria Inclusion criteria Most common OCT findings after vitrectomy in PDR are normal fovea (28.3%), ERM (21.7%) and macular thickening (15%). Visual prognosis is correlated with OCT findings of macula after diabetic vitrectomy. Good visual outcomes were found when postoperative OCT shows normal, ERM, and edema outside of fovea. Moderate visual outcomes were found in macular thickening, macular cystic change, and subfoveal HE. Poor visual oucomes were found in subfoveal fibrosis, macular hole, loss of fovea depression, and serous foveal detachment. a. Normal fovea without macular traction b. Normal fovea with macular traction c. Normal fovea with preretinal hemorrhage d. Tractional retinal detachment (TRD) involving fovea e. Cystoid macular edema (CME) with epiretinal membrane f. Vitreomacular traction syndrome (VMT) OCT classification before PPV OCT classification after PPV a. Normal b. Epiretinal membrane (ERM) c. Macular thickening (CMT>300μm) d. Macular cystic change e. Edema outside of fovea f. Loss of foveal depression g. Subfoveal hard exudates h. Subfoveal fibrosis i. Macular hole / lamellar hole j. Serous foveal detachment Changes of BCVA and macular appearance in OCT after PPV Preoperative OCT findings No. BCVA (logMAR, mean ± SD) Pre-op Post-op p-value * Normal fovea with or without macular traction 20 0.86 ± 0.70 0.32 ± 0.33 0.003 Normal fovea with preretinal hemorrhage 17 1.36 ± 0.95 0.44 ± 0.49 0.002 TRD involving fovea 8 1.59 ± 1.07 0.51 ± 0.32 0.018 CME with ERM 8 0.87 ± 0.60 0.51 ± 0.35 0.166 VMT 7 0.90 ± 0.40 0.63 ± 0.24 0.126 * Paired T-test Frequency of macular appearance in OCT after PPV ERM: epiretinal membrane, MT: macular thickening, MC: macular cystic change, SF: subfoveal fibrosis, EOF: edema outside the fovea, HE: subfoveal hard exudates, LFD: loss of foveal depression, MH/LH: macular hole/lamellar hole, SFD: serous foveal detachment Patients No. (%) Postoperative macular appearance Postoperative macular appearance in OCT Postoperative BCVA (logMAR) Visual prognosis after PPV according to post-operative OCT findings Good prognosis Moderate prognosis Poor prognosis Changes of BCVA according to postoperative OCT findings Postoperative OCT findings No. (%) BCVA (logMAR, mean ± SD) Pre-op Post-op p-value * Normal 17 (28.3) 0.94 ± 0.82 0.11 ± 0.18 0.001 Epiretinal membrane 13 (21.7) 0.82 ± 0.61 0.33 ± 0.33 0.025 Macular thickening 9 (15.0) 1.11 ± 0.83 0.64 ± 0.42 0.240 Macular cystic change 5 (8.3) 1.73 ± 0.95 0.64 ± 0.31 0.188 Edema outside of fovea 3 (5.0) 1.73 ± 1.20 0.36 ± 0.15 0.175 Loss of foveal depression 2 (3.3) 1.80 ± 0.90 0.90 ± 0.57 0.460 Subfoveal hard exudates 3 (5.0) 1.47 ± 0.33 0.60 ± 0.20 0.379 Subfoveal fibrosis 5 (8.3) 0.98 ± 0.25 0.76 ± 0.14 0.086 Macular hole/lamellar hole 2 (3.3) 0.80 ± 0.28 0.85 ± 0.08 0.795 Serous foveal detachment 1 (1.7) 1.3 1 - * Paired T-test Purpose Patients and Methods Retrospective study From Jan 2012 to Dec 2013 Preoperative OCT findings (n) Postoperative OCT findings n (%) BCVA (logMAR, mean ± SD) Pre-op Post-op p-value * Normal fovea with or without macular traction (20) NL ERM EOF MT SF 8 (40) 7 (35) 3 (15) 1 (5) 1 (5) 0.74 ± 0.6 0.63 ± 0.41 1.73 ± 1.20 0.49 1.00 0.13 ± 0.24 0.43 ± 0.42 0.36 ± 0.15 0.49 0.70 0.039 0.028 0.018 Normal fovea with preretinal hemorrhage (17) NL ERM MT HE LFD MH/LH 7 (41.2) 2 (11.8) 5 (29.4) 1 (5.9) 1 (5.9) 1 (5.9) 1.34 ± 1.00 1.35 ± 0.92 0.88 ± 0.40 0.60 1.30 0.80 0.06 ± 0.09 0.20 0.78 ± 0.53 0.60 1.30 0.80 0.016 0.032 0.792 TRD involving fovea (8) NL ERM MT MC 1 (12.5) 2 (25) 1 (12.5) 4 (50) 0.30 0.65 ± 0.21 3.00 2.03 ± 0.77 0.30 0.31 ± 0.30 0.52 0.65 ± 0.35 0.117 0.054 CME with ERM (8) NL ERM MC SF LFD SFD 1 (12.5) 2 (25) 1 (12.5) 2 (25) 1 (12.5) 1 (12.5) 0.10 1.15 ± 1.20 0.60 0.95 ± 0.49 0.49 1.00 0.10 0.45 ± 0.35 0.60 0.75 ± 0.21 0.49 1.00 0.451 0.500 VMT (7) MT SF HE MH/LH 2 (28.6) 2 (28.6) 2 (28.6) 1 (14.3) 0.95 ± 0.92 1.00 0.70 0.90 0.40 ± 0.14 0.75 ± 0.21 0.60 ± 0.28 0.90 0.500 0.348 0.698 Changes of BCVA according to preoperative OCT findings NL: normal fovea, ERM: epiretinal membrane, MT: macular thickening, MC: macular cystic change, SF: subfoveal fibrosis, EOF: edema outside of fovea, HE: subfoveal hard exudates, LFD: loss of foveal depression, MH/LH: macular hole/lamellar hole, SFD: serous foveal detachment, * Paired T-test