Researchers recently described a novel OCT feature called outer retinal hyperreflective deposits (ORYDs) present in the early postoperative phase in the majority of patients after pars plana vitrectomy with ILM peeling for treatment-naïve diabetic macular edema (DME).

This retrospective cohort study included 111 eyes of 111 patients (mean age 67.5±14.8) with naïve DME treated by vitrectomy and ILM peeling who were followed for 24 months after surgery. The team analyzed OCT scans for the presence of ORYDs one week and one, six, 12, 18 and 24 months post-op. They measured changes in baseline best-corrected visual acuity (BCVA) and central subfoveal thickness over the follow-up period and correlated the presence of ORYDs with baseline characteristics and BCVA after 24 months.

They identified ORYDs in the outer plexiform layer in 92 patients (82.8%) seven days after surgery. They note, however, that these deposits were not present before surgery. They add that there was a significant reduction in the presence of ORYDs as the follow-up period progressed, with ORYDs disappearing in all cases after 24 months. 

The authors speculate that the deposits might result from a sudden reduction of inflammation and “could shed new light on” the process of DME resolution after surgical intervention.

Iglicki M, Loewenstein A, Barak A, et al. Outer retinal hyperreflective deposits (ORYD): a new OCT feature in naïve diabetic macular edema after PPV with ILM peeling. Br J Ophthalmol. August 7, 2019. [Epub ahead of print].