Abstract
Purpose :
Diabetic hard exudates can be responsible of visual decrease when they are located in the macular area. The aim of this study was to assess the evolution of diabetic hard exudates over an eight-week period, using a high resolution adaptive optics camera.
Methods :
Prospective observational study. Six eyes of four patients presenting diabetic maculopathy with hard exudates were studied. Selection criteria were intended to ensure good image quality. A multimodal imaging of an area of clinically visible exudates was conducted, encompassing retinography, spectral domain OCT and adaptive optics imaging. Images were acquired for two months, on a weekly basis. A time-lapse video of the region of interest imaged using adaptive optics was obtained for each eye studied.
Results :
Two patterns of progression were identified on adaptive optics:
1- Some eyes showed exudates dislocation concomitant with the regression of the underlying macular edema with hard exudates being progressively replaced by a multitude of focis of smaller size (n=2). In one eye, exudates regressed despite a worsening of the macular edema.
2- Other eyes displayed an increase in size of hard exudates (n=3). In one eye, hard exudates increased progressively according to a circinate pattern centered on a retinal microanevrysm.
Conclusions :
This is the first report documenting precisely the change in appearance of diabetic hard exudates in such a short period of time. During follow up, hard exudates seemed to break-up on a multitude of focis before their resorption. At the opposite, some exudates increased in size. Additional studies assessing the efficacy of the different treatments available for diabetic hard exudates are warranted.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.