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Ilkay Kilic Muftuoglu, Nadia Mendoza, RAOUF GABER, MOSTAFA RAGHEB, Qisheng You, William R Freeman; Integrity of Outer Retinal Layers After Resolution of Central Involved Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3243. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the integrity of outer retinal layers (ORL) after resolution of central involved diabetic macular edema (DME) and to study the effect of various baseline factors on the final visual acuity (VA) and the percentage of ellipsoidal layer (ISe) damage.
Fifty-nine eyes of 48 patients with DME that were successfully treated were included. Several parameters including visual acuity (VA), central subfield thickness (CST), maximum foveal thickness (MFT), foveal volume (FV), ellipsoidal layer (ISe) and external limiting membrane (ELM) damage at the time of DME, and treatment modalities including intravitreal injections and/or macular laser (grid/focal) were considered. Eyes with laser scars located within the 1mm central fovea were excluded.
Thirty-eight eyes had no ORL damage, 21 had ISe and/or ELM damage after complete resolution of DME. Of 21 eyes, 11 had ISe damage between 1-30%, 10 had 31-100% ISe damage. In univariate analysis, although baseline ISe damage and ELM damage was both found to be significantly associated with final VA, ISe layer had a slightly higher association with final VA (odds ratio: 1.0627, 95% CI: 2.3-10.3, p=0.0014 and odds ratio: 1.112, 95% CI: 3.5-19.5, p=0.0036, respectively). Multivariate analysis revealed that Ise (odds ratio: 1.06, 95% CI:1.016-1.105), and VA (odds ratio: 5.977, CI: 1.167-30.622, p=0.032) at the time of DME was significantly associated with impaired vision, whereas baseline ISe damage (odds ratio: 1.05, 95% CI:1.019-1.083), FV (odds ratio: 1.011, 95% CI:1.002-1.019), and having macular laser (odds ratio: 6.12, 95% CI: 1.066-35.166) were significant predictors for the final ISe damage.
Outer retinal layers seemed to be damaged at the time of DME and after resolution of DME as well. The photoreceptor integrity and vision at the time of DME may be valuable for predicting post-DME vision and ORL damage.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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