Assessment of the Morphology of Diabetic Macular Edema Using Optical Coherence Tomography


background: Diabetic macular edema(DME) is a major cause of visual loss in patientswith diabetes. It usually results from the breakdown of the inner blood–retinal barrier.Early detection of retinal abnormalities is vital in preventing diabetic macular edemaand subsequent loss of vision. Until recently, the methods available for detecting andevaluating diabetic macular edema were slit-lamp bio microscopy and stereoscopicphotography, both of which are limited in detecting earlier retinal changes. Optical coherencetomography (OCT) is a new diagnostic imaging modality that provides high-resolution,cross-sectional images of the eye. It is proving to be an accurate tool for the early diagnosis,analysis and monitoring of retinopathy. It allows not only the qualitative diagnosis of diabeticmacular edema, but also the quantitative assessment of edema.Objective: To verify different morphological types of diabetic macular edema that needsdifferent treatment strategies.Patients and methods: A descriptive observational study was done in the OCT unit ofImmam Hussain eye center in Kerbala city from December 2010 to May 2013. OCT done for420 eyes of 237 patient. Cases with low image quality and cases with other eye disease wereexcluded.Results: Of 420 eyes,211 eyes (50.4%) have OCT morphological appearance of diffusespongiform DME,115 eyes (27.5%) mixed spongiform and cystoid edema, 56 eyes (13.3%)have cystoid changes, and 38 eyes ( 9% ) showed edema with traction at vitreoretinalinterface.Conclusion: Optical Coherence Tomography based classification of diabetic macular edemais more accurate in identifying the morphological types that need specific regimes oftreatment and in the follow up the response to treatment.