The Anatomical Basis of Visual Performance in Macular Edema: A Novel Predictive Approach to Analysis Using OCT

Abstract

Abstract: : Purpose: To determine whether visual performance in the presence of macular edema may be related to specific retinal elements connecting the inner and outer retina. Methods: Twenty–two subjects with macular oedema underwent logMAR visual acuity (VA) testing and OCT at baseline and following therapeutic intervention. The number of intact retinal elements present in the Z–plane (IRE) connecting the inner and outer retina was determined and cross–correlated with VA and retinal thickness Results: A significant correlation was found at baseline between the number of IRE and both VA (P=0.02) and retinal thickness (P= 0.005). At 3–months following therapeutic intervention a significant correlation was maintained between the number of IRE at baseline and VA (P=0.05) but not with retinal thickness ( P= 0.17). This trend was maintained to 12 months follow up. Conclusions: Intact Z–plane columns at the macula may be an important predictor of visual performance in macular oedema and may predict a response to therapeutic intervention more accurately than the central foveal thickness.

Keywords: diabetic retinopathy • imaging/image analysis: clinical • macula/fovea