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Laurent Kodjikian,1 Amélie Lecleire-Collet,2 Corinne Dot,3 Marie-Laure Le Lez,4 Stéphanie Baillif,5 Ali Erginay,6 Eric Souied,7 Eric Fourmaux,8 Philippe Gain,9 Anne Ponthieux10 1Department of Ophthalmology, Croix-Rousse University Hospital, Lyon, France; 2Mathilde Clinic, Rouen, France; 3Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France and French Military Health Service Academy, Val-de-Grâce, Paris, France; 4Ophthalmology Department, Centre Hospitalier Regional Universitaire de Tours, Tours, France; 5Department of Ophthalmology, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur-2, Nice, France; 6Department of Ophthalmology, Lariboisière Hospital, AP HP, University Paris-Diderot Paris-7, Paris, France; 7Department of Ophthalmology, Hospital Intercommunal de Creteil, University Paris Est Creteil, Creteil, France; 8Centre Gallien, Bordeaux, France; 9Ophthalmology Department, University Hospital, Saint-Etienne, France, Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint‐Etienne, France; 10Novartis Pharma SAS, Rueil-Malmaison, FranceCorrespondence: Laurent KodjikianDepartment of Ophthalmology, Croix-Rousse University Hospital, 103 Grande Rue de la Croix-Rousse, Lyon, 69004, FranceTel +33 4 26 10 94 29Fax + 33 4 72 07 26 45Email Kodjikian.laurent@wanadoo.frPurpose: To evaluate the real-world effectiveness of intravitreal ranibizumab 0.5 mg (Lucentis) in improving visual acuity (VA) in adults with decreased VA due to diabetic macular edema (DME).Patients and Methods: Real-world prospective observational 24-month study. Ranibizumab-naïve patients (n=116) were enrolled, treated and followed up according to investigators’ usual procedures. Outcomes included change from baseline to month 24 in best-corrected VA (BCVA; primary outcome), central retinal thickness (CRT), treatment exposure and safety.Results: Overall, 62.9% of patients completed the study per protocol, 68.6% completed the induction phase (first three injections one month apart). On average, patients had 12.5 ophthalmologist visits and 5.74 injections in year 1, decreasing to 4.6 visits and 1.94 injections in year 2. Mean baseline BCVA was 58.4 letters, mean gain at M24 was +6.08 letters (95% CI: 2.95, 9.21). Gains were higher for patients who completed induction, and for patients who did not switch treatment. Mean CRT improved by 149.17 μm at M24. There were no new safety signals. BCVA variation of ≥ 6 letters by M3 was predictive of BCVA gains at M24 (p=0.007), as was hypertension medication at baseline (p=0.022).Conclusion: Real-world ranibizumab treatment improved VA in DME patients, despite fewer injections than recommended.Keywords: real-world study, retinal thickness, visual acuity, switch, induction

AimsClinical outcomes of diabetic macular edema (DME) have been widely described, but data on diabetic retinopathy perceptions by diabetes patients are limited. The aim of this survey was to explore the lived experience, knowledge, fears and expectations about disease, and treatment in patients with diabetes and macular edema treated with intravitreal injections (IVTI) and to characterize patient profiles.MethodsCross-sectional survey including a preliminary qualitative phase (20 patients with DME, treated or treatment-naive, 5 female and 15 male, age 36–74 years) followed by a quantitative survey (116 patients treated with IVTI for DME). Data ASKIA Analyze (version 5.3.3.5) was used for descriptive statistics, and R software (version 3.4.1) for multiple correspondence analysis.ResultsThe qualitative phase identified the wording used by patients and information helpful to propose modalities of response in the quantitative phase. In the quantitative survey (116 patients, mean age 66.6 years), most patients were treated with anti-vascular endothelial growth factor. Overall, 71.9% reported that the disease negatively affected their daily activities and 33.1% considered that regular visits to the ophthalmologist were disrupting their life. Treatment expectations differed significantly between patients in terms of disease experience (visit and injection schedules), fears and feelings, and relationship with physicians, allowing three patient profiles to be identified: “Worried” patients (n = 45) felt isolated and were worried about the need for repeated treatment and possible side effects. They were mainly active men aged 2 years; “Curious” patients (n = 21) experienced insufficient support and requested more information on their disease and existing treatments. They were mainly single women aged 60–69 years; “Passive” patients (n = 50) felt sufficiently informed by their ophthalmologist and were not concerned by DME. They were older (mean age: 70 years) and mainly type 2 diabetic men.ConclusionsPatients with diabetes and macular edema treated with IVTI form a heterogeneous group regarding fears and expectations. Different patient profiles were identified and need to be confirmed in larger studies. A better understanding of psychological profiles may optimize compliance of diabetic patients.

Resume – Les progres recents de l’imagerie retinienne l’ont rendue plus precise, moins invasive, et ont permis une evaluation performante de l’ensemble de la retine grâce a differents examens complementaires (imagerie multi-modale). – Les photographies du fond d’œil obtenues avec le retinographe non mydriatique sont une alternative a l’examen du fond d’œil realise par l’ophtalmologiste pour le depistage de la retinopathie diabetique. Les retinographes grand et ultra grand champ facilitent l’analyse de la peripherie de la retine, et limitent le recours a l’angiographie retinienne a la fluoresceine. – La tomographie a coherence optique (OCT) permet le diagnostic et le suivi de l’œdeme maculaire de maniere extremement precise et reproductible. Grâce a l’apparition de l’OCT-angiographie, il est dorenavant possible de visualiser la circulation dans les vaisseaux retiniens maculaires sans injection de colorant. – L’angiographie retinienne avec injection de fluoresceine conserve des indications, mais celles-ci ont beaucoup diminue.

To report a case of tubulointerstitial nephritis and uveitis syndrome (TINU syndrome) with unusual unilateral neuroretinitis.An 11-year-old girl who developed anterior uveitis 3 months after acute tubulointerstitial nephritis, without any etiologic factors for either nephritis or uveitis, is presented.Several days after the anterior uveitis, the patient presented with unilateral optic disk edema associated with a serous retinal detachment of the posterior pole, never previously described in TINU syndrome, leading to the formation of perifoveal intraretinal exudates.In spite of these posterior lesions, clinical course confirmed the previously reported favorable visual outcome of TINU syndrome treated with corticosteroids. It appeared that ocular impairment in TINU syndrome could be more diffuse and more extensive than previously described. As well as the whole uveal tract, the retina and the optic nerve may also be the ocular targets of the idiopathic inflammatory response in TINU syndrome. (Eur J Ophthalmol 2004; 14: 334-7).

International audience; Context: Maternally inherited diabetes and deafness (MIDD) is a rare form of diabetes with a matrilineal transmission, sensorineural hearing loss, and macular pattern dystrophy due to an A to G transition at position 3243 of mitochondrial DNA (mtDNA) (m.3243A>G). The phenotypic heterogeneity of MIDD may be the consequence of different levels of mutated mtDNA among mitochondria in a given tissue.Objective: The aim of the present study was thus to ascertain the correlation between the severity of the phenotype in patients with MIDD and the level of heteroplasmy in the blood leukocytes.Participants: The GEDIAM prospective multicenter register was initiated in 1995. Eighty-nine Europid patients from this register, with MIDD and the mtDNA 3243A>G mutation, were included. Patients with MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) or with mitochondrial diabetes related to other mutations or to deletions of mtDNA were excluded.Results: A significant negative correlation was found between levels of heteroplasmy and age of the patients at the time of sampling for molecular analysis, age at the diagnosis of diabetes, and body mass index. After adjustment for age at sampling for molecular study and gender, the correlation between heteroplasmy levels and age at the diagnosis of diabetes was no more significant. The two other correlations remained significant. A significant positive correlation between levels of heteroplasmy and HbA1c was also found and remained significant after adjustment for age at molecular sampling and gender.Conclusions: These results support the hypothesis that heteroplasmy levels are at least one of the determinants of the severity of the phenotype in MIDD.Heteroplasmy levels are at least one of the determinants of the severity of the phenotype of maternally inherited diabetes and deafness.

We assessed the prevalence and determinants of retinal and renal complications in patients with maternally inherited diabetes and deafness (MIDD).This was a multicentre prospective study comparing the prevalence of retinopathy and renal disease in 74 patients with MIDD and 134 control patients matched for sex, age and clinical presentation at onset of diabetes, duration of diabetes and current treatment. Comparisons were adjusted for HbA(1c) and hypertension.In MIDD patients, HbA(1c) (7.6 +/- 1.6 vs 8.5 +/- 2.0%, p0.002), systolic blood pressure (126.6 +/- 16.2 vs 133.1 +/- 17.3 mmHg, p0.007) and prevalence of hypertension (33.8 vs 64.2%, p0.0001) were lower than in control patients. Prevalence of diabetic retinopathy was 3.7-fold lower in MIDD patients (6/74, 8 vs 40/134, 29.6%, p0.0001). Differences between groups remained significant after adjustment for hypertension, systolic blood pressure and HbA(1c). In MIDD, urinary albumin excretion (314.8 vs 80.1 mg/24 h, p = 0.035) and creatinine plasma levels (103.5 vs 82.2 micromol/l, p = 0.0178) were higher and GFR was lower. Impaired renal function (GFR60 ml/min) was four- to sixfold more frequent in MIDD. Differences between MIDD and control diabetic patients further increased when adjusted for HbA(1c) and systolic blood pressure (p0.0001). Adjustment for treatment with an ACE inhibitor or angiotensin II receptor antagonist did not modify the results.This study indicates that diabetic retinopathy is less prevalent in MIDD than in control diabetes. This suggests that retinal alterations due to mitochondrial disease may have a protective role. By contrast, nephropathy is far more frequent in MIDD, suggesting the presence of a specific renal disease independent of diabetic nephropathy.

Aims There is a need for evaluation of screening and grading services for diabetic retinopathy (DR) in compliance with quality-assurance (QA) standards. We describe the screening/grading QA programme set up for OPHDIAT © over the 2005–2006 period. Methods Screening and grading objectives, evaluation criteria and minimum acceptable QA standards were set. To ensure the quality of DR photos, the proportion of nongradable photos in at least one eye had to be less than 10%. To ensure grading accuracy, intergrading agreement had to be greater than 90%. Grader-generated reports had to be available in less than 48h for more than 80% photos. Readers had to grade 500 to 3000 photos per year. Results Sixteen screening centres were opened between June 2004 and December 2006, and 14,769 patients were screened. Percentages of nongradable photos were consistently below the QA requirement (less than 10%). Overall, 800 photos were graded a second time by a reader blinded to original grading; agreement between graders ranged from 92 to 99%. More than 90% of grader-generated reports were produced within 48h. The number of readings by each grader nearly achieved the QA standard. Conclusion QA for DR telescreening should be a continuous process to provide performance feedback, thus guaranteeing a high standard for delivered results. Almost all of the predetermined QA standards in OPHDIAT © for screening and grading were met. Besides the quality/sensitivity of the screening/grading modalities, it is important to evaluate at-risk patients so that they can be treated efficiently; this should be addressed in a global QA programme.

Objective International and national guidelines recommend an annual funduscopic examination for all diabetic patients, but such annual fundus examinations are not sufficiently performed in France. Non-mydriatic fundus photography is a valid method of evaluation for diabetic retinopathy (DR) and a viable alternative to ophthalmoscopy. After two pilot studies demonstrated the feasibility of telemedical screening for diabetic retinopathy in both hospital and primary-care settings, we developed a regional telemedical network, OPHDIAT © , designed to facilitate access to regular annual evaluations of patients with diabetes while saving medical time. Materials and methods OPHDIAT © comprises peripheral screening centres equipped with non-mydriatic cameras, where fundus photographs are taken by technicians linked by telemedicine to a reference centre, where ophthalmologists grade the images. Currently in the Ile-de-France region, 16 screening centres are linked through a central server to an ophthalmologic reading centre and includes 11 centres located in the diabetes departments of 11 hospitals, one diabetic retinopathy screening centre located in northern Paris, three in healthcare centres and one in a prison. Results During the 28-month evaluation period, 15,307 DR screening examinations were performed. Retinal photographs of at least one eye could not be graded in 1332 patients (9.7%) and diabetic retinopathy was detected in 3350 patients (23.4%). After the screening examination, 3478 patients (25.2%) were referred to an ophthalmologist for either DR, cataract and/or non-gradable photographs. Conclusion Fundus photography combined with telemedicine has the potential to improve the regular annual evaluation for diabetic retinopathy. The organization of the network around a central reading centre serves to guarantee quality control.

Objectifs Les photographies du fond d’œil realisees avec un retinographe non mydriatique constituent la methode de reference pour le depistage de la retinopathie diabetique. L’objectif de cette etude est de valider une classification simplifiee de la retinopathie diabetique, adaptee au depistage par photographies du fond d’œil. Patients et methode Cent vingt et un patients diabetiques ont eu trois photographies couleur du fond d’œil, analysees par quatre lecteurs differents selon la classification de depistage proposee, ainsi qu’un examen de reference (panoramique des 9 champs et examen tomographique par coherence optique de la macula). Resultats La classification de depistage proposee etait simple a utiliser car elle reposait sur la comparaison visuelle des trois photographies du fond d’œil avec des photographies standard. Elle a permis de diagnostiquer les stades severes de retinopathie diabetique avec une sensibilite de 100 % et une specificite de 50 a 58 % lorsque l’examen de depistage mettait en evidence une retinopathie non proliferante moderee ou plus grave. Elle a egalement permis de diagnostiquer un œdeme maculaire avec une sensibilite de 96 a 97 % et une specificite de 89 a 91 %. De plus, les resultats de l’examen de depistage selon cette classification etaient tres reproductibles (concordance inter-lecteur : kappa pondere = 0,78-0,93). Conclusion Cette etude confirme la fiabilite de la classification simplifiee proposee. Le stade seuil de retinopathie diabetique au-dessus duquel cette strategie de depistage n’est plus valable est celui de retinopathie diabetique non proliferante minime. Ainsi, a partir du stade de retinopathie non proliferante moderee mis en evidence sur l’examen de depistage, un examen de la totalite du fond d’œil est recommande. Les formes severes doivent etre prises en charge sans delai par l’ophtalmologiste.

Purpose: Full-thickness macular hole associated with diabetic macular oedema is a rare feature and its pathogenesis remains incompletely elucidated. We report the occurrence of a full-thickness macular hole, documented with optical coherence tomography (OCT), in a patient with diabetic cystoid macular oedema treated by intravitreal triamcinolone injections. Case Report: A 48-year-old woman with refractory diabetic cystoid macular oedema underwent successive intravitreal triamcinolone injections, which were followed by a progressive thinning of the neurosensory retina at the fovea, and then by a full-thickness macular hole, associated with a perifoveal posterior hyaloid detachment, visible on OCT. During pars plana vitrectomy, a thin epiretinal macular membrane was diagnosed and removed. Discussion: Pathogenesis of the present full-thickness macular hole associated with diabetic macular oedema is different from that of idiopathic macular holes because anteroposterior vitreous tractions were not involved in its formation. Recurrent intravitreal triamcinolone injections may have had an indirect role in the development of the macular hole, by favouring the rupture of distended Muller cells and intraretinal pseudocysts.

Purpose To assess preoperative and postoperative infra-clinical macular changes in macula-off retinal detachment (RD) using third-generation optical coherence tomography (OCT3). Design Prospective observational cohort study. Methods Twenty-two nonconsecutive eyes of 22 patients with macula-off RD underwent best-corrected visual acuity measurement and OCT3 scans through the fovea before and after successful surgery. The relationship between preoperative and postoperative OCT macular characteristics, postoperative infra-clinical foveal detachment, and final visual acuity (FVA) were assessed using Kruskal-Wallis multiple comparison test and Mann-Whitney U test, respectively. Results Preoperative cystic cavities in the inner nuclear layer of the detached retina, postoperative abnormal macular profile, and postoperative lack of the junction line between photoreceptor cell inner and outer segments on OCT3 were associated with a poorer FVA ( P = .001, P = 10 −4 and P = .015, respectively). In contrast, postoperative infra-clinical foveal detachment did not influence FVA ( P = .88). Conclusions Morphologic macular analysis using OCT3 provide some new insights to understand incomplete visual recovery after successful macula-off RD surgery.

Nous rapportons le cas d’une neuropathie optique unilaterale atypique chez un homme âge de 45 ans, dont le bilan etiologique a permis la decouverte d’un syndrome primaire des anti-phospholipides. Malgre la presence d’une acuite visuelle initiale effondree ayant persiste plusieurs semaines, la recuperation visuelle a ete complete. Une neuropathie optique atypique peut conduire au diagnostic etiologique de syndrome primaire des anti-phospholipides, necessitant la mise en place d’un traitement par anti-coagulants oraux au long terme, afin d’assurer une meilleure prevention des complications thrombotiques generales potentielles ulterieures.

PURPOSE To determine whether preoperative optical coherence tomography (OCT) is useful in predicting postoperative visual outcome for patients with primary macula-off rhegmatogenous retinal detachment (RD). METHODS This prospective study included 20 nonconsecutive eyes with macula-off RD and successful reattachment of the retina. Preoperative 5-mm OCT was performed through the center of the fovea. The relationship among preoperative OCT findings, main preoperative clinical variables, and final postoperative visual acuity was statistically analyzed. RESULTS Final postoperative visual acuity was negatively correlated with three preoperative OCT variables: height of RD at the central fovea (r=0.79; P

To report the evolution of diabetic macular edema (DME) after extensive panretinal photocoagulation in patients with Type 1 diabetes exhibiting florid proliferative diabetic retinopathy (FPDR).This retrospective observational case series comprised 17 eyes of 10 consecutive patients (8 women and 2 men). All patients exhibited FPDR combined with severe DME, and all underwent panretinal photocoagulation. The evolution of visual acuity and progression of FPDR were evaluated. The evolution of DME during follow-up was assessed by fluorescein angiography and repeated optical coherence tomography examinations.At baseline, all eyes had diffuse DME. Mean logMAR visual acuity was 0.402 +/- 0.46. Mean central macular thickness was 468.23 +/- 113.63 microm. After panretinal photocoagulation, DME regressed spontaneously in all eyes after a mean follow-up of 7.1 +/- 2.68 months. Mean central macular thickness decreased to 268.12 +/-54.67 microm (t-test, P0.0001). Mean visual acuity improved significantly to 0.184 +/- 0.12 (t-test, P = 0.048). Diabetic macular edema only recurred in two eyes.In DME combined with FPDR, extensive panretinal photocoagulation and glycemic control seem effective in reducing DME and improving vision. In FPDR, DME may be caused by excessive production of vascular endothelial growth factor by the unperfused retina.

A case of maternally inherited diabetes and deafness (MIDD)-associated macular pattern dystrophy with a 15-year follow-up is reported. On initial examination at age 37, visual acuity was normal, but chorioretinal atrophy at the posterior pole was already present in both eyes. At age 52, visual acuity remained normal in the right eye and was only slightly decreased in the left eye despite notable extension of the areas of chorioretinal atrophy in that eye. No evidence of diabetic retinopathy was present at any time. This case shows that visual acuity can remain stable in the long term despite extensive lesions of macular pattern dystrophy.

Fundus photographs using a nonmydriatic digital camera are the reference method for diabetic retinopathy screening today. The aim of this study was to validate a simplified diabetic retinopathy classification, adapted for diabetic retinopathy screening, including all diabetic retinopathy severity scales.One hundred and twenty-one diabetic patients had three digital color fundus photographs taken, which were graded by four independent ophthalmologists according to the proposed screening classification, and a reference examination (nine field fundus photographs and optical coherence tomography examination of the macula).The proposed diabetic retinopathy screening classification was easy to use, as it was based on a visual comparison between the three digital color fundus photographs and standard retinal photographs. This classification provided the diagnosis of severe levels of diabetic retinopathy with high sensitivity and accurate specificity (100% and 50%-58%,respectively, for a moderate nonproliferative diabetic retinopathy level or higher on the screening examination) and the diagnosis of macular edema with a high sensitivity and specificity (96%-97% and 89%-91%, respectively). The results of the screening examination using this classification were highly reproducible (weighted k for interobserver agreement: 0.78-0.93).These results suggest that this new simplified classification is accurate. The screening method should not be used above the threshold level of mild nonproliferative diabetic retinopathy. Thus, from the moderate nonproliferative level (inclusive), a complete fundus examination should be undertaken. Severe levels of diabetic retinopathy will be referred to an ophthalmologist without delay for laser treatment.

To compare the effect of classic Joint Photographic Experts Group (JPEG) and JPEG2000 compression algorithms on detection of diabetic retinopathy (DR) lesions.In total, 45 colour fundus photographs obtained with a digital nonmydriatic fundus camera were saved in uncompressed Tagged Interchanged Files Format (TIFF) format (1.26 MB). They were graded jointly by two retinal specialists at a 1 month interval for soft exudates, hard exudates, macular oedema, newvessels, intraretinal microvascular abnormalities (IRMA), and retinal haemorrhages and/or microaneurysms. They were compressed to 118, 58, 41, and 27 KB by both algorithms and 24 KB by classic JPEG, placed in random order and graded again jointly by the two retina specialists. Subjective image quality was graded, and sensitivity, specificity, positive and negative predictive values, and kappa statistic were calculated for all lesions at all compression ratios.Compression to 118 KB showed no effect on image quality and kappa values were high (0.94-1). Image degradation became important at 27 KB for both algorithms. At high compression levels, IRMA and HMA detection were most affected with JPEG2000 performing slightly better than classic JPEG.Performance of classic JPEG and JPEG2000 algorithms is equivalent when compressing digital images of DR lesions from 1.26 MB to 118 KB and 58 KB. Higher compression ratios show slightly better results with JPEG2000 compression, but may be insufficient for screening purposes.

Purpose To prospectively compare the efficacy and safety of 4 vs 2 mg intravitreal triamcinolone acetonide (TA) injection for diabetic macular edema. Design Interventional case series. Methods patients: Thirty-two patients with diabetic macular edema unresponsive to laser photocoagulation. intervention: Patients were randomly assigned to receive 4 or 2 mg intravitreal TA in one eye (16 patients in each group). main outcome measures: The main outcome was central macular thickness (CMT) measured by optical coherence tomography (OCT) at four, 12, and 24 weeks. Secondary outcomes were gain in Early Treatment Diabetic Retinopathy Study (ETDRS) scores, intraocular pressure (IOP), cataract progression, and duration of effect. Results Before injection, mean (± SD) CMT was 564.5 ± 119 μm and 522.9 ± 148.5 μm in the 4- and 2-mg groups, respectively. At four, 12, and 24 weeks after injection, it was 275.0 ± 79.8, 271.4 ± 128.7, and 448.7 ± 146.4 μm, respectively, in the 4-mg group, and 267.3 ± 82.4, 289.8 ± 111.4, and 394.7 ± 178.9 μm, respectively, in the 2-mg group. At no time was the difference in CMT between both groups statistically significant ( P > 0.3). The between-group differences in the gain in the ETDRS score and in IOP were not statistically significant either. Diabetic macular edema recurred after a median period of 20 weeks vs 16 weeks in the 4- and 2-mg groups, respectively ( P = 0.11). Conclusions In the short term, intravitreal injection of 4 or 2 mg TA does not have different effects on CMT, visual acuity, or IOP.

We describe a 45-year-old male patient with an atypical unilateral optic neuropathy who was diagnosed with primary antiphospholipid syndrome. The initially poor vision lasting several months completely recovered and long-term oral anticoagulation therapy prevented potential further systemic thrombotic complications.

International audience; BACKGROUND/AIMS: Neuronal degeneration has been reported to occur in diabetic retinopathy before the onset of detectable microvascular abnormalities. To investigate whether advanced glycation end products (AGE) could be directly responsible for retinal neurodegeneration, retinal explants were incubated with glycated bovine serum albumin (BSA). METHODS: Retinal explants obtained from non-diabetic adult rats were incubated 4 days with or without 200 mug/ml glycated BSA. Neural apoptosis was quantified by terminal dUTP nick end labelling (TUNEL) binding and immunostaining with anti-cleaved caspase-3 antibody. Expression of glial fibrillary acidic protein (GFAP) was localised by immunofluorescence. RESULTS: TUNEL and cleaved caspase-3 positive cells increased significantly by 2.2-fold and 2.5-fold in retinal explants incubated in glycated BSA (p

Purpose Little information is available about the natural history of vitreomacular traction (VMT) associated with diabetic macular edema. A few cases of spontaneous resolution of VMT associated with diabetic macular edema have been described, but have not been documented by optical coherence tomography (OCT). The authors report the spontaneous resolution of VMT associated with diabetic macular edema 1 month after the end of panretinal photocoagulation therapy (PRP). Methods Case report: A 66-year-old woman presented with complicated proliferative diabetic retinopathy and diabetic macular edema associated with VMT, documented by OCT, in the right eye. Left eye examination showed complete PRP and ischemic maculopathy. PRP was immediately realized in the right eye in regard to the presence of complicated proliferative diabetic retinopathy. Results One month after the end of PRP, right eye visual acuity improved. OCT examination showed complete release of foveal posterior hyaloid traction, and significant reduction in foveal thickness. The follow-up was 1 year. At the end of follow-up, visual acuity slightly improved again; only a small residual foveal retinal thickening remained. Conclusions The authors report spontaneous resolution of VMT associated with diabetic macular edema, probably facilitated by PRP, with concurrent reduction of macular thickness and visual improvement. As spontaneous resolution may occur in some eyes with diabetic macular edema associated with VMT, a period of observation after the end of the PRP may be considered prior to vitrectomy.