Abstract
Purpose :
To compare spectral domain optical coherence tomography (SDOCT) characteristics of pseudophakic cystoid macular edema (pCME) in patients with and without diabetes.
Methods :
Spectralis® (Heidelberg Engineering Inc., Franklin, MA) was queried for all FastMAC 25 line SDOCT scans performed for pCME diagnosed within 6 months of cataract surgery at an urban university hospital between 1/1/2011 and 8/31/2016. Spectralis, high speed B-scans centered on the fovea (250 μm line spacing, 5 scans) obtained at diagnosis of pCME were reviewed. Trained graders analyzed the central 1mm zone of each scan for presence of external limiting membrane (ELM) or ellipsoid zone (EZ) disruption, hyperreflective foci (HF), hard exudates (HE), subretinal fluid (SRF), location of intraretinal cysts, central foveal thickness (CFT), and central subfield thickness (CST). Retrospective chart review was performed to record relevant clinical characteristics. Inclusion criteria consisted of clinical diagnosis of the disease. Exclusion criteria included prior retinal surgery or macular edema.
Results :
19 eyes from 18 patients were enrolled in the study. Mean age of 11 participants in the non-diabetic group was 77.1 years, with 45% female. Mean age of the 7 participants in the diabetic group (71.4% NPDR, 14.2% PDR) was 70.0 years, with 43% female. Diagnosis of pCME occurred at 64.5 ± 46.3 days post surgery in the non-diabetic cohort, versus 66.3 ± 48.2 days in the diabetic cohort.
ELM was continuous in the foveal slice in 27.2% (95% CI:-0.33, 54.9) of eyes in the non-diabetic (ND) cohort versus 87.5% (0.79, 0.96) of eyes in the diabetic (D) cohort; this observation reached statistical significance (p<0.007). ELM was continuous in the 4 outer slices in 45.4% (0.20, 0.71) of the non-diabetic cohort versus 75.0% (0.51, 0.99) of the diabetic cohort; however, this trend approached but did not reach statistical significance (p<0.13). There was no significant relationship between presence of EZ disruption (ND: 27.2%, D: 50%), HF, HE, and SRF (ND: 54.5%, D:25%); there was also no significant relationship between cyst location (inner layers, outer layers or both), mean CFT (ND:452, D: 353), and mean CST (ND:462, D: 382) across the two cohorts.
Conclusions :
ELM disruption in pCME may be seen more frequently in non-diabetic eyes compared to diabetic eyes. Further studies are needed to elucidate this relationship.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.