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T. Segato, L. Chiesa, P. Radin, E. Pilotto, E. Midena; Diabetic Macular Edema: Functional and Morphological Definition . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3993.
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Purpose: To investigate the relationship between functional and morphological parameters in diabetic macular edema. Methods: 25 consecutive diabetic patients affected by macular edema underwent functional and morphological examination of macular area. Best corrected visual acuity (ETDRS charts), fixation location (and stability) and macular sensitivity were quantified. Fixation pattern and lesion-related macular sensitivity were investigated with fundus-related perimetry (microperimetry; MP1, Nidek Technologies, Italy). Fundus photography, fluorescein angiography and optical coherence tomography documented macular status. Macular edema was classified according to the International Classification of Diabetic Retinopathy. Results: Best corrected visual acuity is significantly related ( p<.001) to the degree of macular edema. Macular edematous areas are characterized by increased retinal thickness with corresponding decrease of retinal sensitivity (p<.001); intermingled area have normal sensitivity. Fixation is always central and stable, and unrelated to the degree of edema or macular thickness. Conclusions: Diabetic macular edema is characterized by a strict and significant relationship between macular sensitivity and morphological aspects of macular area. Fundus-related perimetry may represent an accurate, functional methodology to investigate visual impairment in diabetic macular edema, monitor natural history of the disease and quantify the effects of any therapeutical intervention, from a functional point of view.
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