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      Optical coherence tomography classification of diabetic cystoid macular edema

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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 references17

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          Optical coherence tomography.

          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.

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

              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.
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                Author and article information

                Journal
                Clin Ophthalmol
                Clin Ophthalmol
                Clinical Ophthalmology
                Clinical Ophthalmology (Auckland, N.Z.)
                Dove Medical Press
                1177-5467
                1177-5483
                2013
                2013
                28 August 2013
                : 7
                : 1731-1737
                Affiliations
                Department of Ophthalmology, Minia University, Minya, Egypt
                Author notes
                Correspondence: Heba Radi Atta Allah, Department of Ophthalmology, Minia University, 32 Adnan El-Maleky Street, Minya 61111, Egypt, Tel +20 100 255 4107, Email radi_heba@ 123456yahoo.com
                Article
                opth-7-1731
                10.2147/OPTH.S47987
                3770711
                24039393
                ea44b5c1-2e17-4b92-ba5a-a11af807dbdf
                © 2013 Helmy and Atta Allah, publisher and licensee Dove Medical Press Ltd

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Case Series

                Ophthalmology & Optometry
                optical coherence tomography,cystoid macular edema,diabetic retinopathy

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