Patterns of fundus autofluorescence and optical coherence tomography in diabetic macular edema and functional correlations_Chinese Journal of Ocular Fundus Diseases

Authors：

HongTingting , WangJun , MengXin , 高新晓 , 刘广峰 , 范颖 , 顾铮 , 贾宇颂 , 王华 ,  彭晓燕

Institute of Ophthalmology, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;

Corresponding author：

彭晓燕, Email: drpengxy@163.com

Keywords：

Diabetic retinopathy/complications; Macular edema; Vision disorders/physiopathology; Tomography, optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2014.06.006

Video：

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Objective To assess and classify the features of fundus autofluorescence (FAF) with optical coherence tomography (OCT) in clinically significant diabetic macular edema according to the criteria reported by ETDRS. Methods Eighty-four eyes of 47 diabetic patients with untreated clinically significant macular edema (CSME) diagnosed by OCT/FAF examination were enrolled in this study. The mean BCVA was 0.38±0.26, CRT was (360.23±139.40) μm and volume was (9.59±1.97) mm³. According to the FAF patterns, the CSME patients were divided into normal group (30 eyes), single-spot group (20 eyes), and multiple-spot group (22 eyes). There were 44, 18 and 22 eyes with diffuse edema, cystoid edema and serous retinal detachment, respectively. The correlation of visual acuity with central retinal thickness and total volume of macular was analyzed between different groups. Results In the normal group and the single-spot group, the prevalence of the diffuse type was highest in the OCT (83.3%, 60.0%). In the multiple-spot group, the prevalence of the SRD type was highest in the OCT (50.0%). In the three FAF pattern groups, the BCVA were 0.47±0.26, 0.43±0.30, 0.28±0.19; the CRT were (272.41±48.62), (402.84±134.89), (505.67±135.20) μm; the total volume was (8.67±1.03), (8.94±1.63), (10.79±2.20) mm³. The BCVA were 0.43±0.25, 0.45±0.30, 0.22±0.14; the CRT were (272.41±48.62), (402.84±134.89), (505.67±135.20) μm; the total volume was (8.58±0.95)、(9.22±1.33)、(12.03±2.01) mm³ in eyes with diffuse edema, cystoid edema and serous retinal detachment, respectively(r=-0.31, -0.34; P > 0.05). Correlation analysis showed CRT positively correlated to volume (r=0.85, P < 0.05), BCVA negatively correlated to CRT and volume(r=-0.31, -0.34; P > 0.05). Conclusion There are more diffuse edema eyes in normal group and single-spot group, while serous retinal detachmen in multiple-spot group. FAF correlates better with visual acuity than OCT patterns.

Citation： HongTingting, WangJun, MengXin. Patterns of fundus autofluorescence and optical coherence tomography in diabetic macular edema and functional correlations. Chinese Journal of Ocular Fundus Diseases, 2014, 30(6): 558-561. doi: 10.3760/cma.j.issn.1005-1015.2014.06.006 Copy

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2.	Virgili G, Menchini F, Dimastrogiovanni AF, et al. Optical coherence tomography versus stereoscopic fundus photography or biomicroscopy for diagnosing diabetic macular edema:a systematic review[J]. Invest Ophthalmol Vis Sci, 2007, 48:4963-4973.
3.	Browning DJ, Glassman AR, Aiello LP, et al. Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema[J].Ophthalmology, 2007, 114:525-536.
4.	Schmitz-Valckenberg S, Holz FG, Bird AC, et al. Fundus autofluorescence imaging:review and perspectives[J]. Retina, 2008, 28:385-409.
5.	Vujosevic S, Casciano M, Pilotto E, et al. Diabetic macular edema:fundus autofluorescence and functional correlations[J]. Invest Ophthalmol Vis Sci, 2011, 52:442-448.
6.	Otani T, Kishi S, Maruyama Y. Patterns of diabetic macular edema with optical coherence tomography[J].Am J Ophthalmol, 1999, 127:688-693.
7.	Holz FG, Bindewald-Wittich A, Fleckenstein M, et al. Progression of geographic atrophy and impact of fundus autofluorescence patterns in age-related macular degeneration[J].Am J Ophthalmol, 2007, 143:463-472.
8.	Dinc UA, Tatlipinar S, Yenerel M, et al. Fundus autofluorescence in acute and chronic central serous chorioretinopathy[J]. Clin Exp Optom, 2011, 94:452-457.
9.	Chin K, Finger PT. Autofluorescence characteristics of suspicious choroidal nevi[J]. Optometry, 2009, 80:126-130.
10.	McBain VA, Forrester JV, Lois N. Fundus autofluorescence in the diagnosis of cystoid macular oedema[J]. Br J Ophthalmol, 2008, 92:946-949.
11.	Soliman W, Sander B, Hasler PW, et al. Correlation between intraretinal changes in diabetic macular oedema seen in fluorescein angiography and optical coherence tomography[J].Acta Ophthalmol, 2008, 86:34-39.
12.	Neubauer AS, Chryssafis C, Priglinger SG, et al. Topography of diabetic macular oedema compared with fluorescein angiography[J]. Acta Ophthalmol Scand, 2007, 85:32-39.
13.	Bessho K, Gomi F, Harino S, et al. Macular autofluorescence in eyes with cystoid macula edema, detected with 488 nm-excitation but not with 580 nm-excitation[J]. Graefe's Arch Clin Exp Ophthalmol, 2009, 247:729-734.
14.	Pece A, Isola V, Holz F, et al. Autofluorescence imaging of cystoid macular edema in diabetic retinopathy[J]. Ophthalmologica, 2010, 224:230-235.
15.	Pelosini L, Hull CC, Boyce JF, et al.Optical coherence tomography may be used to predict visual acuity in patients with macular edema[J]. Invest Ophthalmol Vis Sci, 2011, 25:2741-2748.
16.	Xu H, Chen M, Manivannan A, et al. Age-dependent accumulation of lipofuscin in perivascular and subretinal microglia in experimental mice[J]. Aging Cell, 2008, 7:58-68.

1. Klein R, Klein BE, Moss SE, et al. The Wisconsin Epidemiologic Study of Diabetic Retinopathy:ⅩⅦ.The 14-year incidence and progression of diabetic retinopathy and associated risk factors in type 1 diabetes[J]. Ophthalmology, 1998, 105:1801-1815.
2. Virgili G, Menchini F, Dimastrogiovanni AF, et al. Optical coherence tomography versus stereoscopic fundus photography or biomicroscopy for diagnosing diabetic macular edema:a systematic review[J]. Invest Ophthalmol Vis Sci, 2007, 48:4963-4973.
3. Browning DJ, Glassman AR, Aiello LP, et al. Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema[J].Ophthalmology, 2007, 114:525-536.
4. Schmitz-Valckenberg S, Holz FG, Bird AC, et al. Fundus autofluorescence imaging:review and perspectives[J]. Retina, 2008, 28:385-409.
5. Vujosevic S, Casciano M, Pilotto E, et al. Diabetic macular edema:fundus autofluorescence and functional correlations[J]. Invest Ophthalmol Vis Sci, 2011, 52:442-448.
6. Otani T, Kishi S, Maruyama Y. Patterns of diabetic macular edema with optical coherence tomography[J].Am J Ophthalmol, 1999, 127:688-693.
7. Holz FG, Bindewald-Wittich A, Fleckenstein M, et al. Progression of geographic atrophy and impact of fundus autofluorescence patterns in age-related macular degeneration[J].Am J Ophthalmol, 2007, 143:463-472.
8. Dinc UA, Tatlipinar S, Yenerel M, et al. Fundus autofluorescence in acute and chronic central serous chorioretinopathy[J]. Clin Exp Optom, 2011, 94:452-457.
9. Chin K, Finger PT. Autofluorescence characteristics of suspicious choroidal nevi[J]. Optometry, 2009, 80:126-130.
10. McBain VA, Forrester JV, Lois N. Fundus autofluorescence in the diagnosis of cystoid macular oedema[J]. Br J Ophthalmol, 2008, 92:946-949.
11. Soliman W, Sander B, Hasler PW, et al. Correlation between intraretinal changes in diabetic macular oedema seen in fluorescein angiography and optical coherence tomography[J].Acta Ophthalmol, 2008, 86:34-39.
12. Neubauer AS, Chryssafis C, Priglinger SG, et al. Topography of diabetic macular oedema compared with fluorescein angiography[J]. Acta Ophthalmol Scand, 2007, 85:32-39.
13. Bessho K, Gomi F, Harino S, et al. Macular autofluorescence in eyes with cystoid macula edema, detected with 488 nm-excitation but not with 580 nm-excitation[J]. Graefe's Arch Clin Exp Ophthalmol, 2009, 247:729-734.
14. Pece A, Isola V, Holz F, et al. Autofluorescence imaging of cystoid macular edema in diabetic retinopathy[J]. Ophthalmologica, 2010, 224:230-235.
15. Pelosini L, Hull CC, Boyce JF, et al.Optical coherence tomography may be used to predict visual acuity in patients with macular edema[J]. Invest Ophthalmol Vis Sci, 2011, 25:2741-2748.
16. Xu H, Chen M, Manivannan A, et al. Age-dependent accumulation of lipofuscin in perivascular and subretinal microglia in experimental mice[J]. Aging Cell, 2008, 7:58-68.

Chinese Journal of Ocular Fundus Diseases

Patterns of fundus autofluorescence and optical coherence tomography in diabetic macular edema and functional correlations

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