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Outer retinal hyperreflective deposits (ORYD): a new OCT feature in naïve diabetic macular oedema after PPV with ILM peeling
  1. Matias Iglicki1,
  2. Anat Loewenstein2,
  3. Adiel Barak2,
  4. Shulamit Schwartz2,
  5. Dinah Zur2
  1. 1 Ophthalmology Department, Private Retina Service, University of Buenos Aires, Buenos Aires, Argentina
  2. 2 Ophthalmology Division, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  1. Correspondence to Dr Matias Iglicki, Private Retina Service, University of Buenos Aires, Buenos Aires 1414, Argentina; matiasiglicki{at}


Aims We aimed to investigate a novel optical coherence tomography (OCT) finding of outer retinal hyperreflective deposits (ORYDs) in patients with naïve diabetic macular oedema (DMO) seen after small gauge pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling. Furthermore, we evaluated the predictive value of ORYD for visual outcome over 24 months follow-up.

Methods Retrospective cohort study including 111 eyes from 111 patients with naïve DMO treated by PPV and ILM peeling with a follow-up of 24 months. OCT scans were analysed for the presence of ORYD 1 week and 1, 6, 12, 18 and 24 months after surgery. Change in baseline best-corrected visual acuity (BCVA) and central subfoveal thickness (CST) after surgery were measured over the follow-up period. Presence of ORYD was correlated with baseline characteristics and BCVA after 24 months.

Results Hundred and eleven eyes from 111 patients were included (mean age 67.5±14.8 years). ORYD was identified in the outer plexiform layer as hyperreflective deposits in 92 patients (82.8%) 7 days after surgery but it was not present before surgery. There was a significant reduction in the presence of ORYD. After 24 months ORYD disappeared in all cases (p<0.001).

Conclusions We describe a novel OCT feature of ORYD present in the early postoperative phase in the majority of patients after PPV with ILM peeling for naïve DMO, disappearing over the postoperative course. These deposits might be a result of sudden desinflammation and could shed new light on the process of DMO resolution after operative intervention.

  • retina
  • treatment surgery
  • vitreous
  • imaging
  • inflammation

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  • Contributors MI and DZ contributed to the planning, conduction and reporting of the study. AL, AB and SS contributed to the conduction and reporting of the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Individual Institutional review boards (IRBs) at the participating institutes.

  • Provenance and peer review Not commissioned; externally peer reviewed.