Abnormal retinal fluid in eyes with diabetic center-involved macular edema

Abstract

Purpose : To characterize the two-year occurrence of center-involved macular edema (CIME) in different diabetic retinopathy (DR) risk phenotypes in type 2 diabetes (T2D) and the presence of abnormal retinal fluid accumulation identified by optical coherence tomography leakage (OCT-Leakage).

Methods : A prospective longitudinal cohort study (CORDIS, NCT03696810) was conducted with 3 annual visits (baseline, one- and two-year). Ophthalmological examinations included visual acuity, color fundus photography (CFP), optical coherence tomography (OCT) and OCT-Angiography (OCTA). Only risk phenotypes B (increased CRT) and C (ischemia, decreases in VD ≥ 2 SD of healthy population) were included. Seven-field ETDRS grading was performed. OCT data was analyzed with OCT-Leakage, a novel patented technique by AIBILI for noninvasive assessment of abnormal accumulation of fluid in the retina through low optical reflectivity ratios (LOR).

Results : Of the 122 T2D individuals that completed the study, 65 eyes (53%) were classified as phenotype B and 57 (47%) eyes as phenotype C. During the 2-year period of follow-up, 23 eyes (19%) developed CIME and 2 (2%) clinically significant macular edema (CSME). Phenotype B was preferentially associated with the development of CIME (31%) in comparison with phenotype C (5%). Patients that developed CIME showed a progressive increase in CRT (β=23.705µm, p<0.001) and LOR changes (β=0.018, p<0.001) with time when compared to patients that did not. This difference remains statistically significant when controlling for age, sex, diabetes duration and HbA1c. Changes in time for CRT, over the two-year period of follow-up, are associated with longitudinal changes in LOR ratios (β=114.831, p<0.001) and with longitudinal changes in VD and PD in the deep capillary plexus (VD: β=2.642, p=0.001; PD: β=130.415, p=0.004). LOR increases are associated with BCVA loss (p=0.052).

Conclusions : CIME may occur in both risk phenotypes and in different ETDRS levels. LOR changes were identified in eyes with CIME. There was a clear association between CRT changes and changes in the deep retinal capillary plexus. LOR changes were associated with BCVA loss.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Longitudinal associations between changes across visits in CRT and OCT-Leakage and retinal microvascular variables.