Tomographic finding of foveal hard exudate in diabetic macular edema

PURPOE: To report the intraretinal location of foveal hard exudate after vitrectomy to treat diabetic macular edema and to evaluate the viual outcome. METHOD: In a propective tudy, the tomographic feature of 11 eye (8 patient) with diabetic macular edema were evaluated with optical coherence tomography after vitrectomy. The intraretinal location of hard exudate at the fovea (anatomic foveola) and the relationhip with viual acuity were invetigated. REULT: With optical coherence tomography, hard exudate were oberved a highly reflective pot in the cro-ectional image. In ix of 11 eye (54.5%), the hard exudate were in the inner portion of the neuroenory retina; the final bet-corrected viual acuity averaged 20/70 in the ix eye. In the remaining five eye (45.5%), hard exudate were depoited not only in the neuroenory retina but alo in the ubretinal pace. In optical coherence tomographic image, ubretinal hard exudate were oberved a highly reflective plaque, which were lightly elevated over the retinal pigment epithelium. The five eye developed a erou retinal detachment at the fovea before or after vitrectomy. ubretinal hard exudate bridged the detached neuroenory retina and the retinal pigment epithelium in two eye. The average final viual acuity level in the five eye wa 20/300. The viual outcome wa ignificantly wore in five eye with ubretinal hard exudate than in ix eye with an intraretinal one (P < .05, Wilcoxon rank um tet). CONCLUION: If erou retinal detachment develop before or after vitrectomy for diabetic macular edema, hard exudate tend to accumulate not only in the neuroenory retina but alo in the ubretinal pace. The viual prognoi i wore in cae of ubretinal exudation.