Objective To observe multimodal imaging characteristics of eyes with diabetic macular edema (DME) complicated with different types of vitreomacular interface abnormalities (VMIA). Methods  A cross-sectional clinical study. A total of 203 consecutive patients (203 eyes) newly diagnosed with DME at Department of Ophthalmology of Baoding First Central Hospital from January 2024 to January 2025 were enrolled. All eyes underwent examinations including best corrected visual acuity (BCVA), optical coherence tomography (OCT), and OCT angiography (OCTA). BCVA was tested using an international standard logarithmic visual acuity chart and converted to logarithm of the minimum angle of resolution (logMAR) visual acuity for statistical analysis. The built-in software of the OCT device automatically measured the central macular thickness (CMT). The OCTA instrument measured the blood flow density of the superficial capillary plexus and deep capillary plexus (DCP) within a 3 mm area of the macular region of the retina. At the same time, it assessed the continuity of the ellipsoid zone (EZ) and the external limiting membrane (ELM), and observed whether there was any disorder of the disorganization of retinal inner layers (DRIL). Based on the characteristics of the OCT images, the affected eyes were classified into the simple DME group, the DME combined with vitreomacular adhesion (VMA) group (DME+VMA group), the DME combined with vitreomacular traction (VMT) group (DME+VMT group), and the DME combined with epiretinal membrane (ERM) group (DME+ERM group). The number of eyes in each group was 99, 56, 20, and 28 respectively. The comparison among multiple groups was conducted using one-way analysis of variance. Results There were no statistically significant differences in patient age (F=0.137), gender composition ratio (χ²=0.023), duration of diabetes (F=0.985), and glycated hemoglobin level (F=0.721) among the simple DME group, DME+VMA group, DME+VMT group, and DME+ERM group (P＞0.05); however, there were statistically significant differences in logMAR BCVA among the groups (F=5.016, P＜0.05). In terms of OCT examination, the CMT in the DME+VMT group was significantly thicker than that in the simple DME group, the DME+VMA group, and the DME+ERM group (F=60.404, P＜0.05). In the DME+VMT group and the DME+ERM group, the proportion of serous retinal detachment and the incidence of DRIL were significantly higher than those in the simple DME group and the DME+VMA group (χ²=25.815, 26.397; P＜0.05). Comparisons of the integrity scores of EZ and ELM between the four groups of affected eyes showed no statistically significant differences (F=1.230, 1.050; P＞0.05). OCTA examination revealed that the DCP blood flow density in the DME+VMT group and the DME+ERM group was significantly lower than that in the simple DME group and the DME+VMA group (F=58.994, P＜0.05). Conclusion  Compared with isolated DME and DME combined with VMA, DME eyes complicated with tractional VMIA (VMT and ERM) exhibit worse BCVA, more severe macular edema, more severe disruption of inner retinal architecture, and more prominent reduction in DCP vessel density.

Citation： Fu Yan, Li Tianhang, Ma Ruoxuan, Gu Zhaohui. Multimodal imaging characteristics of diabetic macular edema with different types of vitreomacular interface abnormalities. Chinese Journal of Ocular Fundus Diseases, 2026, 42(8): 675-680. doi: 10.3760/cma.j.cn511434-20251209-00567 Copy

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