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B.Y. Kim, P.K. Kaiser; Visual Correlations of Optical Coherence Tomography of Diabetic Macular Edema . Invest. Ophthalmol. Vis. Sci. 2005;46(13):372.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To describe the appearance and prevalence of various morphological patterns of diabetic macular edema demonstrated by optical coherence tomography (OCT); and to evaluate the visual acuities associated with these specific OCT patterns. Methods: A retrospective chart review of all patients with clinically–evident diabetic macular edema who underwent OCT evaluation at the Cole Eye Institute between May 1998 and December 2002 was performed. The OCT scans were evaluated for the presence of retinal thickening, cystoid macular edema, hyaloidal traction, serous retinal detachment, and traction retinal detachment. In addition, the foveal retinal thickness was measured, and visual acuity was recorded for each patient. Results: A total of 199 eyes from 144 patients were identified. OCT revealed at least five distinct morphologic subgroups of diabetic macular edema: diffuse retinal thickening (192, 96%), cystoid macular edema (114, 57%), subretinal fluid without posterior hyaloidal traction (21, 11%), posterior hyaloidal traction without traction retinal detachment (28, 14%), and posterior hyaloidal traction with traction retinal detachment (3, 2%). The mean retinal thickness varied within each subtype: diffuse retinal thickness averaged 411.0 +/–132.9 microns, cystoid macular edema 473.7 +/–126.0 microns, subretinal fluid without posterior hyaloidal traction 547.1 +/–93.0 microns, posterior hyaloidal traction without traction retinal detachment 448.9 +/–123.9 microns, and posterior hyaloidal traction with traction retinal detachment 576.8 +/–124.3 microns. The mean visual acuities (recorded in logMar units) for each group were as follows: diffuse retinal thickening 0.69, cystoid macular edema 0.79, subretinal fluid without posterior hyaloidal traction 0.82, posterior hyaloidal traction with traction retinal detachment 1.0, and posterior hyaloidal traction without traction retinal detachment 0.77. Increasing retinal thickness was significantly correlated with worse visual acuities (p < 0.005). The OCT patterns of cystoid macular edema (p = 0.01) and posterior hyaloidal traction without traction retinal detachment (p = 0.02) were also significantly associated with worse vision as well. Conclusions: Diabetic macular edema exhibits at least five different morphologic patterns on optical coherence tomography with varying incidence rates. There is a significant correlation between retinal thickness and visual acuity. In addition, specific OCT patterns tended to be associated with worse visual acuities
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