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Spectral domain optical coherence tomography classification of diabetic macular edema: a new proposal to clinical practice

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To classify the types of diabetic macular edema (DME) and evaluate its morphological features on spectral domain optical coherence tomography (SD-OCT) and determine correlations between visual acuity and OCT findings.

Methods

We assessed 406 eyes of 309 patients with a diagnosis of DME retrospectively. Three types based on SD-OCT were identified: diffuse macular edema, cystoid macular edema, and cystoid degeneration. Morphological features such as serous macular detachment (SMD), vitreomacular interface abnormalities (VMAI), hard exudates, photoreceptor status, and correlations between visual acuity and those morphological features were also evaluated by SD-OCT.

Results

The most common type of DME was cystoid edema (68.5%). No statistically significant difference was found between groups in sex (P = 0.40), type of diabetes (P = 0.50), or diabetic retinopathy (P = 0.78). However, the duration of symptoms and BCVA was significantly lower in the group with cystoid degeneration compared with the group with cystoid edema (P < 0.001) and the group with diffuse macular edema (P < 0.001). In the group with cystoid degeneration compared with the groups with cystoid and diffuse edema, the central fovea and central subfield were significantly thicker (both (P < 0.001), the subfoveal choroid was significantly thinner (P = 0.049), rate of serous macular detachment was significantly lower (P < 0.001), and the rate of outer retinal damage was significantly higher (P < 0.001).

Conclusions

Cystoid macular degeneration, which is consistent with poor functional and morphological outcomes, should be differentiated from cystoid macular edema. Serous macular detachment, which is mostly seen in eyes with early stages of DME, should be evaluated as an accompanying morphological finding rather than a type of DME.

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Authors and Affiliations

  1. Istanbul Retina Institute, Hakkı Yeten Cad. Unimed Center No: 19/7 Fulya – Şişli, 34349, Istanbul, Turkey

    Serra Arf, Isil Sayman Muslubas, Mumin Hocaoglu, Mehmet Giray Ersoz & Murat Karacorlu

  2. Department of Ophthalmology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey

    Hakan Ozdemir

Authors
  1. Serra Arf
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  2. Isil Sayman Muslubas
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  3. Mumin Hocaoglu
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  4. Mehmet Giray Ersoz
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  5. Hakan Ozdemir
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  6. Murat Karacorlu
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Correspondence to Murat Karacorlu.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent licensing arrangements), or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (name the institution/committee) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. “For this type of study formal consent is not required.”

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Arf, S., Sayman Muslubas, I., Hocaoglu, M. et al. Spectral domain optical coherence tomography classification of diabetic macular edema: a new proposal to clinical practice. Graefes Arch Clin Exp Ophthalmol 258, 1165–1172 (2020). https://doi.org/10.1007/s00417-020-04640-9

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  • DOI: https://doi.org/10.1007/s00417-020-04640-9

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