Optical coherence tomography in diabetic macular edema: patterns and related risk factors

Abstract

Introduction: Diabetic Macular Edema (DME) is an important cause of vision loss in diabetic retinopathy. Optical Coherence Tomography (OCT) is a non-invasive modality that produces high-resolution images of retinal layers. Objective: To evaluate the prevalence of DME patterns and their association with risk factors and visual acuity. Materials and Methods: In this cross-sectional study, type 2 diabetics with macular edema referred to our center during a ten-month period underwent OCT. Patients with macular edema due to causes other than diabetes and with OCT images of improper quality were excluded from the study. Four distinct patterns were found in the OCT images. A questionnaire including age, sex, duration of diabetes, serum TG and cholesterol, HbA1c, BMI and visual acuity, as well as the findings of OCT images were filled for the subjects. Results: Eighty-six eyes from 46 patients were evaluated. The most and the least common patterns were sponge-like retinal swelling (SLRS) and posterior hyaloidal traction (PHT) found in 64.0% and 5.8% of the subjects, respectively. A sub-retinal fluid pattern was more common in males (p=0.011) and in patients with serum TG > 200mg/dl (p=0.037). There were significant associations between central foveal (r=0.45, p<0.001), nasal (r=0.35, p=0.001) and temporal (r=0.32, p=0.003) thicknesses with visual acuity. Moreover, the highest thickness (462.4±119.2µm) and also the worst visual acuity (1.0±0.5logMAR) pertained to the cystoid macular edema (CME) pattern. Conclusion: Our study showed that the most common OCT pattern of DME is the sponge-like retinal swelling, while posterior hyaloidal traction has the lowest prevalence. A higher foveal thickness and a lower visual acuity are seen in the CME pattern.

Spectral Domain Optical Coherence Tomography in the Diagnosis and Monitoring of Diabetic Macular Edema

“…OCT offers a high resolution image of a limited area. Since OCT uses light to acquire images, its use is limited by media opacities [5,6].…”

“…It offers qualitative information on retinal thickness, and it is reliable and reproducible. OCT reveals the presence and extension of vitreo-macular traction (VMT) [5,6].…”

“…OCT technology holds the promise for the unprecedented capability to describe and monitor the changes in retina geometry. distance between the vitreo-retinal interface and the anterior surface of the RPE is generally comprised between 200 and 275 μm; the foveal depression ranges from 170 to 190 μm and the thickness of the peripheral retina is between 220 and 280 μm [5].…”

Optical coherence tomography in diabetic macular edema: sub-retinal fluid pattern and related risk factors

“…We read with interest the article by Ahmadpour-Baghdadabad M et al (2013) in which the authors studied the association of various patterns of diabetic macular edema (DME) with the risk factors of DME based on the optical coherence tomography (OCT) findings.…”

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We read with interest the article by Ahmadpour-Baghdadabad M et al (2013) in which the authors studied the association of various patterns of diabetic macular edema (DME) with the risk factors of DME based on the optical coherence tomography (OCT) findings.In a retrospective cross-sectional study, we too evaluated the systemic risk factors associated with sub-retinal fluid (SRF) pattern of DME. We compared 37 eyes with SRF pattern of DME (designated cases) versus 30 eyes having DME (sponge like retinal swelling or cystoid macular edema) without SRF (designated controls) on spectral domain-OCT. We too found that the SRF pattern was more common in males than in females (84.8 % of cases were males versus 66.7 % of controls).

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