Long-term results of excision of plaque-like foveal hard exudates in patients with chronic diabetic macular oedema

Abstract

Objective To analyse the long-term results of surgical removal of plaque-like diabetic foveal hard exudates. Methods In this retrospective, interventional, non-randomized, controlled study, vitrectomy and excision of submacular hard exudates was performed on 11 eyes of 11 patients with plaque-like hard exudates. The mean preoperative LogMAR best corrected visual acuity (BCVA) and exudate diameter were 1.35 +/- 0.3 and 1.19 disks ( range, 0.5 - 1.8), respectively. In the control group, which consisted of 10 eyes of 7 patients who refused the surgery, baseline mean BCVA and exudate diameter were 1.06 +/- 0.2 and 1.2 disks ( range, 0.7 - 2.0), respectively. Main outcome measures included BCVA, fundus photography, and surgical complications.Results The mean follow- up was 39.1 +/- 3.2 months for the study group and 32.5 +/- 3.6 months for the control group. In the study group, BCVA improved in 8 (73%) eyes at the final examination. The mean final BCVA was 1.08 +/- 0.4 (P=0.021). Macular oedema and exudates resolved completely in all eyes. In the control group, final LogMAR visual acuity declined to 1.53 +/- 0.1 (P=0.005). Macular pigment epithelium atrophy or scar formation was observed in 7 (64%) eyes in the study group and in all eyes in the control group.Conclusion Surgical excision of plaque-like foveal hard exudates resulted in better anatomical and functional outcome when compared to observation alone.