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Abstract

Purpose To propose a new classification of diabetic cystoid macular edema (CME) based on optical coherence tomography (OCT) findings and cover all new important findings. Patients and methods A retrospective study was carried out in the El-Minia Investigation Eye Center between January 2012 and November 2012. It included 104 eyes of 86 patients, aged between 50 and 71 years, all with type II diabetes mellitus of duration from 5 to 20 years. All patients were diagnosed to have CME, as assessed by OCT, with measurement of the vertical size of the largest macular cyst and maximum macular thickness, and the relation between them. Results Patients were divided into four groups. Eyes with cysts less than 30% of macular thickness were considered to have CME I (n = 4, 3.84%), while those between 30% and 60% were considered to have CME II (n = 62, 59.62%). Eyes with cysts between 60% and 90% of macular thickness were considered to have CME III (n = 36, 34.62%). CME IV was diagnosed when the size of the cyst became more than 90% of the macular thickness, and this was encountered in two eyes (1.92%). Conclusions OCT is a useful technique for quantitative measurement and helps in better anatomical characterization of CME, and this classification of diabetic CME may be of value in classification of CME due to causes other than diabetes.

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Most cited references 17

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Optical coherence tomography.

D. Huang, E Swanson, C. Lin … (1991)

A technique called optical coherence tomography (OCT) has been developed for noninvasive cross-sectional imaging in biological systems. OCT uses low-coherence interferometry to produce a two-dimensional image of optical scattering from internal tissue microstructures in a way that is analogous to ultrasonic pulse-echo imaging. OCT has longitudinal and lateral spatial resolutions of a few micrometers and can detect reflected signals as small as approximately 10(-10) of the incident optical power. Tomographic imaging is demonstrated in vitro in the peripapillary area of the retina and in the coronary artery, two clinically relevant examples that are representative of transparent and turbid media, respectively.

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Diabetic retinopathy.

John Klein, Jerry Cavallerano, Craig F. Ferris … (1997)

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Correlation between visual acuity and foveal microstructural changes in diabetic macular edema.

Yumiko Yamaguchi, Tomohiro Otani, Shoji Kishi (2010)

The purpose of this study was to investigate the correlation between best-corrected visual acuity and foveal microstructural changes of the external limiting membrane and the junction between the inner and outer segments of the photoreceptors in diabetic macular edema. The authors performed spectral-domain optical coherence tomography in all eyes. The authors defined central subfield thickness as the average retinal thickness of the 1-mm central scanned area. The length of disruption of the external limiting membrane and the inner and outer segments of the photoreceptors in the fovea (1.8 mm in diameter) were measured and graded according to their length as follows: 1) >1.4 mm; 2) >0.4 mm but <1.4 mm; or 3) <0.4 mm. The best-corrected visual acuity was strongly associated with the external limiting membrane (r = 0.66) and inner and outer segments of the photoreceptor (r = 0.68) scores, whereas best-corrected visual acuity was weakly and negatively correlated with central subfield thickness (r = -0.23). Spectral-domain optical coherence tomography showed that the integrity of the external limiting membrane and inner and outer segments of the photoreceptors was more strongly correlated with best-corrected visual acuity when compared with central subfield thickness in diabetic macular edema.