ObjectiveTo 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. ResultsIn 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). ConclusionThere 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.