Perifoveal microcirculation before and after vitrectomy for diabetic cystoid macular edema.

Abstract

To quantify the perifoveal microcirculation in diabetic eyes before and after successful vitreous surgery for cystoid macular edema without posterior vitreous detachment, and to determine whether improvement in perifoveal microcirculation is associated with improvement in postoperative visual acuity. In a prospective study, vitreous surgery was performed on 11 eyes of nine consecutive diabetic patients with cystoid macular edema, and their mean perifoveal capillary blood flow velocity was measured by fluorescein angiography with a scanning laser ophthalmoscope. Visual acuity was measured preoperatively and postoperatively, and the results were converted to the logarithm of the minimum angle of resolution (logMAR). The correlation between changes in logMAR visual acuity and capillary blood flow velocity was evaluated. In all nine eyes of seven patients with successful vitreous surgery, the cystoid macular edema resolved within 6 months after surgery, and the mean capillary blood flow velocity was significantly increased compared with that before surgery (2.19 mm per second versus 2.68 mm per second, P =.021); the changes in capillary blood flow velocity were significantly correlated with the changes in the logMAR visual acuity (P =.024). Vitreous surgery may improve perifoveal microcirculation in the eyes of diabetic patients with cystoid macular edema and resolve the macular edema. Improvement of perifoveal microcirculation may be an important factor affecting visual outcome.