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Ei Tae Kim, Jang won Heo; Analysis of morphologic changes and treatment prognosis in intraretinal cystoid diabetic macular edema using SD-OCT. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3426.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the morphologic changes of intraretinal cyst using SD-OCT and treatment outcome of intraretinal cystic type diabetic macular edema.
Clinical records of 85 eyes with intraretinal cystoid diabetic macular edema were analyzed retrospectively for 24 months. All subjects were underwent SD-OCT and fluorescein angiography. Patients were treated with, either intravitreal triamcinolone injection / anti-VEGF injection or vitrectomy. The consecutive morphologic changes of intraretinal cystoid space in SD-OCT were analyzed after each treatment. The visual acuity and central retinal thickness (CRT) were also analyzed after treatment to understand treatment prognosis.
The treatment group is composed with 28 eyes of IVTA, 35 eyes of anti-VEGF injection and 12 eyes of vitrectomy. The intraretinal cystoid space was remained in 26 of 28 eyes (92.9%) in IVTA, 32 of 35 eyes (91.4%) in anti-VEGF injection and 5 of 12 eyes (41.7%) in vitrectomy group. There is no significant difference between IVTA eyes and anti-VEGF injection eyes (P=0.884) however, significant difference in vitrectomy eyes (P<0.05). The changes of visual acuity (logMAR) were 0.645±0.212 to 0.598±0.413 (P=0.156) in the IVTA eyes, 0.596±0.356 to 0.544±0.276 (P=0.210) in the anti-VEGF injection eyes and 0.821±0.348 to 0.878±0.487 (P=0.301) in the vitrectomy eyes, and there was no significant difference between pre- and posttreatment visual acuities. The changes of CRT were 333.8±93.5μm to 317.8±83.0μm (P=0.126) in the IVTA eyes, 325.4±73.6μm to 310.7±68.6μm (P=0.224) in the anti-VEGF injection eyes and 349.2±87.5μm to 269±77.6μm (P=0.07) in the vitrectomy eyes, and there was decrease but no significant difference in CRT after each treatment. There was no correlation between visual acuity and CRT also.
In this study, the intraretinal cystoid diabetic macular edema seems to persist despite any treatment. The visual acuity and CRT also did not respond well to any treatment. The intraretinal cystoid diabetic macular edema can be classified as refractory type.
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