Vitreo-Macular Traction in Persistent Edema

March 25, 2009

Sometimes, even after good laser treatment and kenalog injections for diabetic macular edema, the edema persists or quickly recurs. Instead of repeating the laser (with its inherent risk of ischemia and burn creep which may worsen vision) or kenalog, it would be a good idea to consider an OCT to rule out VMT, as depending on the degree of traction, vitrectomy with/without peel may relieve the traction and lessen the edema. Furthermore, the vitrectomy may increase the oxygen tension in the eye which itself may improve the macular function. So, if getting frustrated with stubborn macular edema, consider vmt!

 

 



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2 Responses to “Vitreo-Macular Traction in Persistent Edema”

  • Dr. Weitzner

    i am not a retinologist, so i cant answer your dye q! and i dont have too much experience here, as this situation doesnt come up too often. maybe, hopefully, other retinologists will chime n!

  • Wow, I haven’t “heard” much of this for a long time! I am glad to hear there are others that still have some of the “old” problems. I have found that the vision improvement, in absence of an obvious ERM, is modest and takes months to achieve. Do you use ICG dye to stain?

    Another reason to consider vitrectomy in these situations is more long term. It has been my impression that diabetic eyes that have received ERM/ILM removal may become stable over time, i.e. less macular edema, etc.

    I look forward to hearing from you.

    Thanks,

    Randall V. Wong, M.D.
    Vitreo Retinal Specialist
    http://www.TotalRetina.com

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