Work

Structural and Functional Improvement in Persistent Macular Edema Following Internal Limiting Membrane Peeling Coupled With Integrated Optical Coherence Tomography–Guided Cyst Puncture of Intracystic Hyperreflective Material

Year: 2025

Type: article

Abstract: Purpose: To describe a novel surgical approach for eyes with persistent macular edema (ME) complicated by intracystic hyperreflective material. Methods: Pars plana vitrectomy and dye-assisted internal limiting membrane (ILM) peeling were performed in cases with chronic and/or refractory intracystic hyperreflective material. Microscope-integrated optical coherence tomography (OCT) was used to localize cysts and intracystic hyperreflective material, perform cyst puncture, and monitor cyst collapse. Functional and structural outcomes were assessed longitudinally over a minimum follow-up of 3 months. Results: Decimal visual acuity improved from a median of 0.28 (20/71.4) to 0.50 (20/40) over a median follow-up of 6 months. No patient required repeat intravitreal injection or experienced recurrence of intracystic hyperreflective material. Conclusions: ILM peeling combined with integrated OCT-guided cyst puncture may improve outcomes and reduce treatment burden in eyes with persistent ME and intracystic hyperreflective material. Additional controlled studies are needed to establish the broader utility of this technique.

Source: Journal of VitreoRetinal Diseases

DOI: 10.1177/24741264251383408

Authors: Abhishek Upadhyaya, Ritesh Narula, Brijesh Takkar

Institution: L V Prasad Eye Institute

Language: English

Topic: Retinal and Macular Surgery

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funder: Hyderabad Eye Research Foundation