الفهرس 
AcknowledgementsOnly 14 pages are availabe for public view
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Abstract
Aim of the work: To record various morphologic patterns of tractional diffuse diabetic macular oedema demonstrated by optical coherence tomography (OCT) and correlates them with functional and anatomical results after pars plana vitrectomy.Patients and methods: Diagnosis of tractional diffuse diabetic macular edema by optical coherence tomography (OCT). Eyes were divided according to the relationship of the posterior hyaloid to the retina into vitreomacular traction (VMT) group and epi-retinal membrane group (ERM) group. Eyes with VMT underwent PPV with or without ILM peeling. Eyes with ERM underwent either PPV with or without ILM peeling or intra-vitreal injection of TA with or without macular laser photocoagulation. Preoperative and postoperative best corrected visual acuity (BCVA) and macular thickness were compared. Follow-up visits performed at 1month, 3 months and 6 months.Results: This study was a prospective interventional study of seventy five eyes of diabetic patients, they showed diabetic macular edema (DME) with evidence of traction either antero-posterior or tangential traction. The study was conducted at Mansoura University Ophthalmic Center in the period between 2012 and 2016 with at least 6 months follow up. The main outcomes in the study were the postoperative visual acuity as a functional outcome and the central foveal thickness as an anatomical outcome. The effect of multiple predictors was examined for functional outcomes. More than 2/3 of the cases were found to have ERM compared to VMT cases which represent (29.3%) evidenced by OCT. vitrectomy in VMT and ERM group showed highly statistically significant improvement of Log MAR BCVA and central foveal thickness after surgery (P<0.0001) . Conclusion: vitrectomy has favorable results in cases of tractional diffuse diabetic macular edema as regard functional and anatomical outcomes with maintained effect.