Fluid aspiration from intraretinal cysts for refractory diabetic macular edema

To report the surgical outcome of fluid aspiration in intraretinal cysts as a novel treatment approach for the refractory cystoid macular edema (CME) associated with diabetic retinopathy. This retrospective consecutive case series examined eight patients with refractory CME who underwent intraretinal cyst fluid aspiration using a 38-gauge subretinal infusion needle during pars plana vitrectomy. We reviewed changes in central retinal thickness (CRT), best-corrected visual acuity (BCVA), and central sensitivity among patients followed up for 12 months post-surgery. CRT on optical coherence tomography (μm) significantly improved at 12 months post-surgery (308 ± 99) compared to before surgery (480 ± 141) (P < 0.005). During the follow-up period, CME relapsed in one eye. The BCVA (logarithm of the minimal angle of resolution) at 12 months post-surgery (0.23 ± 0.32, Snellen equivalent: 20/50) was significantly better than the preoperative BCVA (0.39 ± 0.29, Snellen equivalent: 20/63) (P < 0.01). The mean deviation value of central sensitivity did not significantly change between preoperative (-2.5 ± 2.1) and postoperative (-2.2 ± 2.2) assessments (P = 0.07). Fluid aspiration in intraretinal cysts may be a treatment option for refractory CME in eyes with diabetes.