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  Indian J Med Microbiol
 

Figure 1: A 56-year-old woman with type 2 diabetes mellitus was diagnosed with center-involved diabetic macular edema in her OS. Her visual acuity at baseline was 20/150. She underwent six consecutive intravitreal injections of 1.25-mg bevacizumab, three intravitreal injections of ranibizumab, macular laser photocoagulation, and two injections of 4 mg of triamcinolone acetonide. Despite these treatments, her diabetic macular edema did not improve. She then underwent pars plana vitrectomy. Her diabetic macular edema resolved, but her visual acuity did not improve. (a) Pre-pars plana vitrectomy infrared reflectance image of the left eye. As this is a confocal image, notice that the image is out of focus. (b) Pre-pars plana vitrectomy spectral domain-optical coherence tomography of the left-eye foveal cut. Notice the intraretinal hyporeflective spaces and the discontinuation of the ellipsoid and external limiting membrane. (c) Post-pars plana vitrectomy infrared reflectance image of the left eye. The diabetic macular edema has resolved. Notice that the image is in focus, and the macular scars from the prior macular laser photocoagulation are clearly in focus. (d) Post-pars plana vitrectomy spectral-domain-optical coherence tomography of the left eye foveal cut. The macula has a normal foveal depression, but the ellipsoid and external limiting membrane are clearly missing

Figure 1: A 56-year-old woman with type 2 diabetes mellitus was diagnosed with center-involved diabetic macular edema in her OS. Her visual acuity at baseline was 20/150. She underwent six consecutive intravitreal injections of 1.25-mg bevacizumab, three intravitreal injections of ranibizumab, macular laser photocoagulation, and two injections of 4 mg of triamcinolone acetonide. Despite these treatments, her diabetic macular edema did not improve. She then underwent pars plana vitrectomy. Her diabetic macular edema resolved, but her visual acuity did not improve. (a) Pre-pars plana vitrectomy infrared reflectance image of the left eye. As this is a confocal image, notice that the image is out of focus. (b) Pre-pars plana vitrectomy spectral domain-optical coherence tomography of the left-eye foveal cut. Notice the intraretinal hyporeflective spaces and the discontinuation of the ellipsoid and external limiting membrane. (c) Post-pars plana vitrectomy infrared reflectance image of the left eye. The diabetic macular edema has resolved. Notice that the image is in focus, and the macular scars from the prior macular laser photocoagulation are clearly in focus. (d) Post-pars plana vitrectomy spectral-domain-optical coherence tomography of the left eye foveal cut. The macula has a normal foveal depression, but the ellipsoid and external limiting membrane are clearly missing