Vitrectomy with ILM peeling and subretinal injections of BSS in diabetic macular oedema in one eye vs. intravitreal anti‐ VEGF injections in the second eye – A swept source OCT angiography study

Abstract Purpose: The aim of this study was to compare the results of vitrectomy performed in patients' worse eyes with diabetic macular oedema to the results of continuous anti‐VEGF treatment performed in patients' fellow eyes. Methods: A retrospective interventional study of patients with diabetic macular edema in both eyes. The better eye was always qualified for aflibercept injections (group 1), and the worse eye was scheduled for vitrectomy (group 2). The follow‐up lasted 12 months. The following parameters were measured: visual acuity (V), central retinal thickness (CRT), maximum retinal thickness (MRT), central choroidal thickness (CCT), superficial (sFAZ) and deep fovea avascular zone (dFAZ), and vessel density at the level of superficial (sVD) and deep (dVD) retinal vessels. Results: None of the analysed factors differed between groups with statistical significance at any timepoint. The time of recovery of vision was identical in both eyes (F = 0.91, p = 0.449). The final sFAZ was significantly smaller for group 2 (median 196 μm), than for group one (median 375 μm; U = 101.0; p = 0.022; r = 0.44). Conclusion: Both techniques resulted in similar improvements in visual acuity and decreases in CRT after one year. sFAZ decreased in all eyes, with a higher extent after vitrectomy.