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

Abstract

Currently, spectral domain optical coherence tomography (SD-OCT) is a basic tool in diagnosing and monitoring diabetic macular edema (DME), which is the most frequent cause of visual impairment in the diabetic patients. OCT technology has changed the classification of DME from the traditional criteria. Macular thickness measured on OCT is considered an outcome measure to evaluate the structural and functional outcome of various therapeutic means used in DME. SD-OCT evaluates ultrastructural retinal parameters, such as the ellipsoid zone, photoreceptor outer segment length and quantifies the individual layers according to various algorithms. The aim is to present the way in which SD-OCT technology has changed our clinical practice during the last years, in diagnosing, classifying and treating DME and to illustrate its impact with practical cases.

Current Management of Diabetic Macular Edema

“…Ten years after ETDRS, Optical Coherence Tomography (OCT) became the new imaging modality that enabled ophthalmologists to utilize the qualitative and quantitative measurement of central subfield macular thickness (CSMT) and visual acuity to diagnose and determine the response of DME to treatment [29,72]. OCT is invaluable due to its reliability and reproducibility; its importance in evaluating and monitoring DME cannot be over-emphasized [41,74].…”

“…DME classification based on OCT is described using various morphology (1) diffuse edema type (sponge-like diffuse retinal thickening), (2) cystoid macular edema (CME) type (thickening of the fovea with intraretinal cystoid change), (3) serous retinal detachment (SRD) type (thickening of the fovea with subretinal fluid) and ( 4) vitreomacular interface abnormalities as seen in incomplete or complete posterior vitreous detachment and epiretinal membrane (ERM) formation or vitreomacular traction or both [74][75][76].…”

“…Other parameters deployed by the OCT in DME diagnosis include retinal thickness, volume (quantitative data), and inner and outer layers of the retina [72,74].…”

Total macular volume as a potential biomarker in the assessment of anti-VEGF response in patients with diabetic macular edema: real-life data analysis

“…Spectral-domain optical coherence tomography (SD-OCT) not only enables us to examine retinal structures layer by layer but also provides us with qualitative and quantitative information related to pathological alterations because of DME in the retina (3). SD-OCT has become a clinic of importance in diagnosis and classifying DME along with monitoring the treatment response (4). Previous studies showed that the assessment of central macular thickness (CMT) is a useful parameter for diagnostic sensitivity and quantitative monitoring in DME (2,3).…”