SYNEK, Svatopluk, Libor PÁČ and Monika SYNKOVÁ. TEM of epiretinal tissue in diabetic macular oedema. Acta Ophthalmologica scandinavica. 2006, 84/2006, No 239, p. 180-182, 2 pp. ISSN 1395-3907.
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Basic information
Original name TEM of epiretinal tissue in diabetic macular oedema
Name in Czech TEM epiretinálnlí tkáně u diabetického makulárního edému
Authors SYNEK, Svatopluk (203 Czech Republic, guarantor), Libor PÁČ (203 Czech Republic) and Monika SYNKOVÁ (203 Czech Republic).
Edition Acta Ophthalmologica scandinavica, 2006, 1395-3907.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30200 3.2 Clinical medicine
Country of publisher Czech Republic
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 1.458
RIV identification code RIV/00216224:14110/06:00018876
Organization unit Faculty of Medicine
Keywords in English TEM; diabetic macular oedema
Tags diabetic macular oedema, TEM
Changed by Changed by: doc. MUDr. Svatopluk Synek, CSc., učo 1561. Changed: 20/10/2006 12:46.
Abstract
Purpose Diabetic cystoid macular oedema (DME) is common cause of visual acuity decrease. Good anatomical results and visual acuity(VA) of pars plana vitrectomy(PPV) in a case of macular hole with internal limiting membrane peeling leeds to usage of this technique in DME. Favourable results even in a case without vitreoretinal traction leeds to conclusion that pathogenesis of this disease is different. Methods 21eyes from 19 patients with DME that had undergone PPV and peeling ILM were analyzed retrospectively. Half of them were laser treated before surgery. All eyes had an attached posterior hyaloids membrane in the macular region, but without thickening and without traction.Parts of excised tissues were examined by transmissive electron microscopy(TEM). Results Median duration of DME at the time of PPV was approximately 11.0 months. The median preoperative best-corrected VA of 0.08, improved to a median postoperative VA of 0.25. 7 eyes without preoperative laser coagulation had a median VA improvement of 77%, while 12 eyes with preoperative macular laser treatment had a median VA improvement of 14.8%. In all 21 eyes, DME was no longer visible on microscopic examination after a median period of 3.0 months after PPV. TEM samples contained ILM, glial cells and connective tissue and can be classified in monolayer membrane, multilayer membrane and true epimacular fibrous membrane. Conclusions PPV and peeling ILM resulted in the resolution of oedema, with an improvement in visual acuity in the majority of cases. Eyes without preoperative macular photocoagulation had a significantly higher visual improvement than eyes with preoperative laser treatment. A randomized controlled prospective trial of PPV versus laser is needed to determine the role of PPV as treatment modality for DME
Abstract (in Czech)
Diabetický cystoidní makulární edém je častou příčinou poklesu zrakové ostrosti. Dobré výsledky s Pars plana vitrektomií u makulární díry s peelingem vnitřní limitující membrány vedly k závěru použít tuto techniku u diabetiků. Navíc dobré výsledky i u nemocných bez vitreoretinální trakce vedly k závěru, že patogeneze obou těchto onemocnění je odlišná. Transmisní elektronovou mikroskopií bylo možné rozdělit epimakulární tkáň na vzorky obsahující vnitřní limitující membránu s kolagenními vlákny, na jednovrstevné buněčné membrány, vícevrstevné buněčné membrány a pravé vazivové epimakulární membrány.
Links
NR8369, research and development projectName: Ultrastruktura vitreoretinálního rozhraní u diabetického makulárního edému
Investor: Ministry of Health of the CR
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