Analysis of changes in structural and functional parameters after surgical treatment of resistant diabetic macular edema

Relevance. Diabetic macular edema (DMO) is the leading cause of vision loss in patients with diabetes mellitus. Currently, injections of angiogenesis inhibitors are the «gold standard» of DMO treatment. Common indications for vitrectomy in diabetic retinopathy include retinal traction detachment, epiretinal membrane, fibrovascular membrane progression despite laser therapy, resistant diabetic macular edema, neovascular glaucoma, and recurrent hemophthalmos that does not respond to conservative therapy. Some surgeons consider it advisable to perform a vitrectomy with the removal of the inner boundary membrane in patients with DME. Target. To analyze changes in the structural and functional parameters of the retina of patients after surgery in the presence of resistant diabetic macular edema. Material and methods. The data of 75 patients (75 eyes) with a diagnosis of DME and a lack of response to previous conservative treatment (laser coagulation, angiogenesis inhibitors) were studied. Results. In groups 2 and 3, after surgical treatment, there was a statistically positive trend in the analysis of ICOS after 6 months in comparison with patients from group 1. According to OCT data, after 1 week and 1 month, the indicators of retinal thickness in the fovea area were lower in group 3 compared with groups 1 and 2. In addition, there was a statistically significant decrease in edema in patients of groups 2 and 3 compared with patients of group 1 at 1, 6 and 12 months. Photosensitivity indices within 1 week after surgery in patients of the 2nd and 3rd groups were significantly higher than in patients of the 1st group. Conclusion. Based on the analysis of the study results, it can be concluded that vitreoretinal surgery has advantages in the treatment of resistant forms of diabetic macular edema, confirming the possibility of choosing a surgical approach. Keywords: DME, diabetic macular edema, BSS, vitrectomy, membrane peeling, submacular surgery