Risk factors and management of diabetes-related macular hard exudates / 中华实验眼科杂志

Diabetes-related macular exudation is a common fundus change associated with diabetes mellitus,charactered by hard exudates of macular area.It is one of main causes of lowing vision in diabetic patients.The incidence of diabetes-related macular exudation is increasing recent years,and therefore the diabetic maculopathy is also a matter of urgent concern.Domestic and international studies suggested that many systemic factors,such as blood glucose level,blood pressure,hypertension,higher blood lipid,inflammatory factors and genetic predisposition,exert impacts in the pathogenesis and development of diabetic retinopathy.However,whether the hard exudates of macular area also is associated with systemic factors mentioned above is unclear up to now.Since the hard exudates of diabetic maculopathy may leads to permanent loss of visual function,it is very important for us to find the effective prevent and managing approaches.This paper aimed to review the progress in this field and summarize the relevant risk factors that must be strictly controlled.

Peeling of Internal Limiting Membrane for Diabetic Macular Edema with Severe Hard Exudates

PURPOSE: To evaluate the results of peeling of internal limiting membrane (ILM) for the treatment of diabetic macular edema with severe hard exudates. METHOD: We analyzed the records of the patients who had macular edema with severe hard exudates, underwent pars plana vitrectomy combined with indocyanine green (ICG)-assisted ILM peeling, and then were followed more than 4 months postoperatively. RESULTS: In 6 patients, 10 eyes, mean age was 60.2 years and follow-up period was 7.3 months. In all eyes, a attached posterior hyaloid was shown, and hard exudates and macular edema began to decrease within 1 week after operation. Visual acuity was less than 0.1 in 6 eyes before operation, in 3 eyes by the best visual acuity during follow-up period and in 4 eyes on the final examination, and 0.15 or better in 2 eyes, 6 eyes and 5 eyes, respectively. According to the best visual acuity, there was improvement in 8 eyes and no change in 2 eyes, and according to the final visual acuity, improvement in 6 eyes, no change in 3 eyes and deterioration in 1 eye. CONCLUSIONS: ICG-assisted ILM peeling would be helpful for the treatment of diabetic macular edema with severe hard exudates.