| Section1Subfoveal choroidal thickness in eyes of patients with diabetic macular edema[Purpose] To study the subfoveal choroidal thickness (SFCT) in eyes of patients with diabetic macular edema (DME).[Methods] An observational cross-sectional study.32eyes of20patients with DME were recruited from Department of Ophthalmology, the First People’s Hospital, Shanghai Jiaotong University. All the patients underwent best corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT). According to the morphology on SD-OCT scans, patients were divided into diffuse macular edema, cystoid macular edema, serous retinal detachment and hard exudate groups. SFCT was obtained by a Cirrus HD-OCT with enhanced depth imaging (EDI) mode.30eyes of20normal subjects were studied in the same time as a control group. The SFCT of DME group was compared with that of control group. Correlation between SFCT and age, diabetic duration, diopter, fasting blood glucose, central retinal thickness (CRT) and BCVA was analyzed by Pearson Analysis. SFCT of different types of DME were analyzed by ANOVA Analysis.[Results] The mean SFCT of the32eyes was223.81±43.74μm (ranging from120.50to361.50μm), which was significantly different (95%CI:-74.83～28.32μm, p<0.001) from SFCT of control group (275.38±7.80μm). SFCT was unrelated with age (r=0.104), diopter (r=0.277), diabetic duration (r=0.289), fasting blood glucose (r=0.340), BCVA (r=0.087) and CRT (r=0.087). SFCT of different types of DME were not significantly different (F=0.032, p>0.05).[Conclusion] Choroidal thickness was thinner in eyes with DME, comparing with normal subjects, and this may correlate with the mechanisms of DME.Section2Correlation between visual function and photoreceptor integrity on spectral-domain optical coherence tomography in diabetic macular edema[Purpose] To evaluate the correlation between visual function and foveal micro structural changes of the inner segment-outer segment junction (IS/OS) and external limiting membrane (ELM) in DME.[Methods] Retrospective, observational, cross-sectional study. A total of40patients (61eyes) diagnosed with DME at Shanghai First People’s Hospital affiliated with Shanghai Jiao Tong University were enrolled. We performed BCVA, macular sensitivity (MS) and SD-OCT in all patients. Several SD-OCT variables, including the integrity of the IS/OS, integrity of the ELM, CRT, and central retinal volume (CRV) were evaluated by2observers who were blinded to the BCVA status of each patient. Main outcome measures were the association of BCVA and MS with the SD-OCT results, including the integrity of the IS/OS, the integrity of the ELM, CRT and CRV.[Results] Patients were divided into3groups each based on the integrity of the IS/OS or ELM:IS/OS (+,±,-) and ELM (+,±,-). A significant difference was found between the IS/OS(+), IS/OS(±) and IS/OS(-) groups in the BCVA (p<0.001) and MS (p<0.001), but not in the CRT (P>0.05) or CRV (P>0.05). The results were similar for the ELM. There was a significant difference among the ELM(+), ELM(±) and ELM(-) groups in the BCVA (p<0.001) and MS (p<0.001), but not in the CRT (P>0.05) or CRV (P>0.05).There was a strong correlation(r=0.881, p<0.001) between ELM and IS/OS integrity for the same patient. The categorization of IS/OS was more severe than that of ELM.[Conclusions] The integrity of IS/OS and ELM was correlated with the visual function of patients with DME. Further studies are needed to confirm and validate this relationship.Section3Characteristics of fundus autofluorescence in patients with diabetic macular edema[Purpose] To investigate the characteristics of fundus autofluorescence (FAF) in DME patients, which is a rapid, noninvasive technique for fundus diseases.[Methods] A total of18patients (30eyes) with clinical significant macular edema (CSME) were enrolled. The FAF imaging was performed with a confocal scanning laser ophthalmoscope (HRA2-cSLO). Other ophthalmic examinations included BCVA, MP-1microperimetry and SD-OCT. Main outcome measurements included BCVA, MS, CRT, CRV, the integrity of IS/OS and the integrity of ELM.[Results] Among the30eyes,4eyes (13.3%) had normal foveal FAF, and26eyes (86.7%) had abnormal FAF. Abnormal FAF was mainly divided into3types: cystoid increased FAF (iFAF)16eyes (53.3%), spot iFAF6eyes (20%), irregular decreased FAF (dFAF)4eyes (13.3%). According to the FAF morphology, patients were categorized into4groups:normal, cystoid iFAF, spot iFAF and irregular dFAF. There was a significant difference in BCVA (P<0.001) and MS (P<0.05) among the4groups. The visual function of patients with spot iFAF and irregular dFAF was relatively poor. However, there was no difference in CRT (P=0.186) and CRV (P=0.191) among the4groups. In the normal FAF group, the photoreceptor layers were mostly intact. Regarding the cystoid iFAF group, the photoreceptor layers were relatively intact. While for the other two groups, IS/OS and ELM were disrupted in most patients. No one had intact IS/OS or ELM layer.[Conclusions] FAF might reflect the damage of the retina and had a relationship with visual function as well as photoreceptor integrity, which gives new insight into the evaluation of DME. Dynamic FAF monitoring helps to better evaluate the disease progression of DME as well as visual function. |
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