J Korean Ophthalmol Soc.  2014 Feb;55(2):222-229. 10.3341/jkos.2014.55.2.222.

Analysis of Optical Coherence Tomographic Patterns and Clinical Courses in Diabetic Macular Edema after Treatment

• Lim JH
• Kim IH
• Bae GH
• Kim HK
• Bae SH

• KMID: 2218415
• DOI: http://doi.org/10.3341/jkos.2014.55.2.222

Abstract

PURPOSE
To analyze the optical coherence tomographic patterns and clinical courses of patients with diabetic macular edema (DME) after treatment.
METHODS
The charts of 65 patients with DME were retrospectively reviewed. Baseline optical coherence tomographic patterns of DME were categorized into the 4 groups: group 1 (9 eyes, 13.8%) showed diffuse retinal thickening, group 2 (21 eyes, 32.3%) had cystoid macular edema (CME), group 3 (13 eyes, 20.0%) demonstrated serous retinal detachment (SRD) and group 4 (22 eyes, 33.9%) had combined CME and SRD. Treatments for DME included intravitreal bevacizumab/triamcinolone injection, focal laser photocoagulation and vitrectomy. During 12 months of follow-up, changes in the patterns of DME were assessed. Additionally, the central retinal thickness (CRT) and best-corrected visual acuity (BCVA) were measured at baseline, 6 and 12 months.
RESULTS
During 12 months of follow-up, 21 eyes (32.3%) showed changes in the DME pattern: 2 eyes (22.2%) in group 1, 3 (14.3%) in group 2, 4 (30.8%) in group 3 and 12 (54.5%) in group 4. A significantly greater proportion of eyes with changes in DME pattern underwent vitrectomy compared with those without changes in DME pattern (p = 0.012). There was a significant difference in CRT among the 4 groups; group 4 demonstrated the largest CRT at baseline, 6 and 12 months (p < 0.001, 0.002 and 0.029, respectively). However, there were no significant differences in BCVA among the 4 groups at baseline, 6 or 12 months (p = 0.879, 0.375 and 0.246, respectively).
CONCLUSIONS
Clinical courses varied according to the tomographic patterns of DME after treatment, and the poorest anatomic outcome was found in group 4. Change in tomographic pattern of DME was correlated with the treatment of DME, which might suggest a poorer outcome in those patients than in the patients who maintained their DME patterns.

Keyword

Diabetic macular edema; Optical coherence tomography; Prognosis; Treatment

MeSH Terms

Follow-Up Studies
Humans
Light Coagulation
Macular Edema*
Prognosis
Retinal Detachment
Retinaldehyde
Retrospective Studies
Tomography, Optical Coherence
Visual Acuity
Vitrectomy
Retinaldehyde

Figure

• 

  Figure 1. The optical coherence tomographic patterns of diabetic macular edema. (A) Diffuse retinal thickening without cyst-like cavities, (B) Cystoid macular edema with decreased optical reflectivity in the retinal layer, (C) Serous retinal detachment, (D) Combination of cystoid macular edema and serous retinal detachment.

• 

  Figure 2. Changes of central retinal thickness (CRT) according to the optical coherence tomographic patterns of diabetic macular edema. Bars indicate averaged CRT in each group. Error bars indicate standard deviations. Asterisks mean statistically significant difference between parameters (p < 0.05). CME = cystoid macular edema; DRT = diffuse retinal thickening; SRD = serous retinal detachment.

• 

  Figure 3. Changes of best-corrected visual acuity (BCVA) according to the optical coherence tomographic patterns of diabetic macular edema. Bars indicate averaged BCVA in each group. Error bars indicate standard deviations. Asterisk means statistically significant difference between parameters (p < 0.05). CME = cystoid macular edema; DRT = diffuse retinal thickening; SRD = serous retinal detachment.

Reference

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