Frequency and Associations of a Taut Thickened Posterior Hyaloid, Partial Vitreomacular Separation, and Subretinal Fluid in Patients With Diabetic Macular Edema

In Brief Purpose: To determine prospectively among patients with diabetic macular edema (DME) the frequency of a clinically evident taut thickened posterior hyaloid (TTPH), optical coherence tomography (OCT) signs suggestive of partial vitreomacular separation (PVMS), and OCT evidence of subretinal fluid (SRF) and to investigate for associations between these findings. Methods: In a prospective case series, patients with DME despite previous laser treatment were examined for the presence of a TTPH. OCT was performed to investigate for PVMS and SRF. Results: One hundred forty patients and eyes were included in the study. A TTPH was present in six patients (4%). PVMS was present in 14 (10%) of 140 patients with DME, of whom 5 also had a TTPH. SRF was present in 15 (11%) of 140 patients, of whom 4 had TTPH. OCT showed that 66% of patients with SRF and DME had neither a clinical TTPH nor partial posterior hyaloid separation. Conclusion: A TTPH was found in 4% of subjects with DME. Partial posterior hyaloid separation and SRF may be found in patients who do not have a TTPH. SRF in patients with DME may not be tractional. A TTPH was found in 6/140 (4%) patients with diabetic macular edema despite previous laser treatment and as such is not a common clinical entity. Partialvitreomacular separation was present in 10% of this population and subretinal fluidin 11%, but in more than 2/3 of cases the one occurred without the other. Our datasuggest that most cases of subretinal fluid in diabetic macular edema may not becausally related to traction arising from partial vitreomacular separation.