Objective To observe the choroidal changes of diabetic macular edema (DME) with serous macular detachment (SMD) in non-proliferative diabetic retinopathy (NPDR) patients by optical coherence tomography (OCT).Methods Nine NPDR patients including DME with SMD in one eye (SMD group) and only DME in the other eye (DME group) were enrolled. These 18 eyes were also divided into PRP group (six eyes, received panretinal photocoagulation before) and non-PRP group (12 eyes). Spectral domain EDI (enhance depth imaging) OCT and fundus photograph were performed in all the eyes. The subfoveal choroidal thickness was measured. The choroidal simulation area acquired by horizontal EDI-OCT scan through the center of the fovea was calculated by Image Plus Pro 6.0 software. The difference between DME and SMD group was compared and analyzed with matched t- test; the difference between PRP and non-PRP group was compared and analyzed with F test.Results In SMD group, spindle-like or domelike low signal of detachment areas with intact external limiting membrane were found in the retinal detachment region, and the inner and outer segments (IS/OS) were separated from the retinal pigment epithelium (RPE) Bruch membrane. Both subfoveal choroidal thickness and choroidal simulation area in SMD group were significant greater than those in DME group (t=2.306, 2.306;P＜0.05). Choroidal simulation area in PRP group was larger than that in nonPRP group (F=5.227,P＜0.05). But there was no significant difference of subfoveal choroidal thickness between PRP and non-PRP group (F=3.276,P＞0.05). Conclusion EDI-OCT detects spindlelike or domelike low signal areas in detachment region of SMD with DME in NPDR patients.
ObjectiveTo investigate the relationship between the posterior vitreous detachment (PVD) and the diabetic macular edema (DME).MethodsA total of 169 eyes with DME which were diagnosed by funduscopy，fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were retrospectively analysed. PVD and partial PVD were detected by OCT and biomicroscopy. The characterizations of OCT images of DME were analysed.ResultsIn 169 eyes, 156 (92.3%) had no PVD with the average thickness of fovea of 297 μm; 11 (6.5%) had complete PVD with the average thickness of fovea of 229 μm; 2 (1.2%) had partial PVD with the average thickness of fovea of 347 μm.ConclusionsOnly a few PVD were found in DME eyes, so traction of PVD may not be the main cause of DME. (Chin J Ocul Fundus Dis, 2003,19:341-343)
Objective To observe and analyze the incidence of macular edema and its related factors after cataract surgery in diabetics with and without diabetic retinopathy. Methods A retrospective study. The data of 90 diabetics including 45 cases with diabetic retinopathy (DR group) and 45 cases without DR (diabetics group) and an equal number of non-diabetic matched controls (control group) who underwent phacoemulcification and intraocular lens implantation were collected. Patients with macular edema before the surgery were excluded. Main outcome measurements included best-corrected visual acuity (BCVA) and central subfield mean thickness (CSMT). Optical coherence tomography (OCT) was used to measure the distance from the inner limiting membrane to the pigment epithelium of the central macular with diameter of 1 mm, which was used as the CSMT. There were no significant differences in BCVA and CSMT among three groups preoperatively (F=1.300, 1.329; P=0.280, 0.273). The BCVA and CSMT before and after the surgery in all three groups were compared. macular edema was defined as an increase of CSMT on OCT ＞30% from preoperative baseline. The incidence of macular edema of three groups after the surgery were compared and analyzed. The correlation between postoperative BCVA and CSMT, and the correlation between diabetes mellitus, DR and macular edema after surgery were analyzed by Logistic regression analysis. Results After the surgery, compared with control and diabetics group, the BCVA in DR group decreased and the CSMT increased significantly and the differences were statistically significant (P＜0.05). However, between control and diabetics group, the differences in BCVA and CSMT after the surgery were not statistically significant (P＞0.05). The incidences of macular edema in DR group (15.6% and 13.3%) 1 month and 3 months postoperatively were significantly more than that in control group (2.2% and 2.2%) and non-DR diabetics group (4.4% and 2.2%), and the differences were statistically significant (χ2=6.696, 6.644; P=0.035, 0.036). Logistic regression analysis showed that the postoperative BCVA was correlated with CSMT (r=0.444, P=0.000), diabetics was not correlated with postoperative macular edema (r=7.231, P=0.999) and DR was correlated with macular edema after surgery (r=0.378, P=0.008). The diabetic retinopathy might correlated to macular edema after surgery. Conclusions The incidence of macular edema after cataract surgery in patients with DR was significantly higher than that in patients without DR. There is no correlation between diabetics and postoperative macular edema, and DR is correlated with macular edema after surgery.