Long-term Results of Excision of Plaque-like Foveal Hard Exudates in Patients with Chronic Diabetic Macular Oedema

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.