Clinical Ophthalmology (Apr 2019)

Optical coherence tomography patterns of diabetic macular edema in a Saudi population

  • Yassin SA,
  • ALjohani SM,
  • Alromaih AZ,
  • Alrushood AA

Journal volume & issue
Vol. Volume 13
pp. 707 – 714

Abstract

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Sanaa A Yassin,1 Saud M ALjohani,1 Arwa Z Alromaih,2 Abdulaziz A Alrushood11Department of Ophthalmology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaPurpose: The study aims to describe the patterns of diabetic macular edema (DME) and their association with visual acuity using optical coherence tomography (OCT).Patients and methods: This is a retrospective observational study with chart review of patients with DME including both type 1 and 2 diabetics seen between January 2015 and January 2016.Main Outcome Measures: Type of diabetes, diabetes duration, best-corrected visual acuity, DME pattern, central macular thickness (CMT), and stage of diabetic retinopathy. DME was classified based on OCT scans into: sponge-like diffuse retinal thickness (SLDRT), cystoids macular edema (CME), and sub-retinal fluid (SRF).Results: 227 eyes (144 patients) were included. The SLDRT represented 67.84%, CME 19.82%, and presence of SRF 2.20%. OCT scan from 21 patients (22 eyes) displayed more than a single pattern. The CMT and visual acuities varied depending on the DME morphologic patterns. SLDRT was associated with the least affected mean visual acuity of 0.2±0.21. SRF signified the worst mean visual acuities. Increase in CMT significantly correlated with reduced visual acuity (P=0.005). A statistically significant positive correlations between diabetic stage—high risk proliferative diabetic retinopathy (PDR) and severe non-proliferative diabetic retinopathy (NPDR)—with the CMT (P=0.050) and (P=0.021) respectively, were observed. A significant positive correlation between the duration of diabetes, age and type 1 diabetes with visual acuity in LogMAR (P=0.003), (P=0.03), and (P=0.0005) respectively.Conclusions: SLDRT was the most common morphological subtype of DME patterns and increasing retinal thickness impaired the visual acuity. Older ages, longer diabetic duration and type 1 diabetes are considered significant risk factors for visual acuity impairment. The study also suggests that there is a significant correlation between the DME patterns and visual acuity.Keywords: diabetic retinopathy, optical coherence tomography pattern, diabetic macular edema, DME morphologic patterns

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