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Structure and Extent of a Diabetic Macular Edema Assessed with Optical Coherence Tomography
Schaudig U., Engelmann K., Mertens S., Richard G.,
Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Augenheilkunde (Hamburg)
Background: The interpretation of two-dimensional cross sectional images obtained with optical coherence tomography (OCT) of the macula could influence therapy if a definite correlation of defined patterns or of the amount of diabetic macular edema with posttherapeutic results could be shown.
Methods: 48 consecutive patients with clinical significant macular edema according to ETDRS criteria were studied with OCT (Zeiss-Humphrey) using topographic retinal mapping of retinal thickness with six 5-mm linear scans through the center of fixation and structural analysis of the pattern of macular edema. Treatment decisions were not based on the OCT results.
Results: The most common sign of macular edema was a diffuse swelling of the retina with reduction of intraretinal reflectivity. Cystoid spaces were present in 50% of the cases, serous retinal detachment in less than 20%. In 23 cases a vitrectomy was performed, leading to changes in intraretinal structure in all cases (reduction of diffuse swelling, loss of intraretinal cystoid spaces, reduction of retinal thickness). Smaller preoperative retinal thickening was indicative of a favorable postoperative result; the different structural forms of diabetic edema had no influence on the posttherapeutic result.
Conclusions: Optical coherence tomography is valuable for documentation of the changes in retinal thickness with diabetic retinopathy. Correlation to visual acuity has been shown for this parameter. Various forms of structural changes in diabetic macular edema can also be differentiated with OCT, but there presence currently remains without influence on treatment decisions.