Correlation between central subfield thickness, visual acuity and structural changes in diabetic macular edema
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Data
2012
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Resumo
Purpose: To correlate the central subfield thickness (CST) measured by Cirrus TM
SD-OCT with best-corrected visual acuity (BCVA) and structural changes in diabetic
macular edema (DME).
Methods: The transversal study evaluated 200 patients with non-proliferative
diabetic retinopathy (NPDR) and selected 55 eyes with DME between January,
2010 and April, 2011. Spectral domain OCT was performed in patients with type
2 diabetes and DME. CST and BCVA were correlated with the edema morphology
and the ELM (external limiting membrane) integrity. Statistical tests were applied
to validate the results.
Results: There was no difference between genders in the NPDR classification. 47.3%
of the patients showed moderate NPDR. The CST average for male was of 393.58 μm
and 434.16 μm for female, with no statistically significant difference. The patients with
continuous ELM showed lower CST average (368.73 μm) than those with disrupted
ELM (521.43 μm). There was a strong correlation between the macular volume and
CST (59.63%), but poor correlation between age and CST (2.9%). Also, there was a
significant difference between the average CST and the type of macular edema.
Patients with serous detachment showed higher CST average (488.71 μm) than
those with cystoid macular edema (CME) and diffuse edema. Patients with severe
NPDR showed higher CST average (491.45 μm), if compared to mild and moderate
NPDR. Cystoid macular edema was the most common type of edema (49.1%) and
showed the worse VA. Patients with disrupted ELM showed worse BCVA. Patients
with higher CST showed worse BCVA. There was a significant difference between the
CST average of the case group (407.6 ± 113,1 μm) and the control group (diabetic
patients without DME: 252 ± 12.5 μm). There was also a significant difference in the
BCVA variables and macular volume between case and control groups.
Conclusion: The study suggests that the CST of diabetic patients with edema is
higher than the control group, the increase in CST of diabetic patients with edema
leads to worsening of BCVA and macular volume. Continuous ELM showed lower
CST average, and the serous detachment showed higher CST average. Cirrus TM
proved to be an important tool in the DME evaluation.
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Palavras-chave
Diabetic retinopathy, Optical coherence, Macular edema, Tomography, Retinopatia diabética, Tomografia de coerência óptica, Edema macular
Citação
HANNOUCHE, Rosana Zacarias et al. Correlation between central subfield thickness, visual acuity and structural changes in diabetic macular edema. Arquivos Brasileiros de Oftalmologia, Rio de Janeiro, v. 75, n. 3, p. 183-187, 2012.