Compare Clinical Diagnosis Methods For Diabetic Macular Edema

Objective: To compare the optical coherence tomographic (OCT) features with clinical and fluorescein angiographic (FA) findings in patients with diabetic retinopathy. And to evaluate the result for diagnosis ofmacular edema.Methods: Ninety-four eyes of 51 DR patients were diagnosed with fundus fluorescein angiography, the clinical examination ( the slit-lamp biomicoscopy with a+90D noncontact lens) and OCT. The detection rate was analyzed by these three methods. OCT was used to measure the retina thickness in the fovea, the results were compared with FA. ANOVA was used for the statistic comparison between the groups. The results of the clinical examination with +90D noncontact lens were also compared with FA. The correlation between retinal thickness at the central fovea and the best corrected visual acuity was analyzed.Result: The detection rate for the diabetic macular edema was 63% with the clinical examination; 87% with FA and 89% with OCT. As FA for the gold standard, we found the coincidence between FA and the clinical examination was 69.1%. The coincidence between FA and OCT was 88.3%. The mean retinal thickness in the central fovea was 140+6.17wn in the control group. OCT images demonstrated retinal edema in 47.9% of eyes, cystoid macular edema (CME) in 12.8%of eyes; serous foveal detachment +swelling in 23.4%of eyes; serous foveal detachment +swelling +vitreous-macular drag in (2.1%) of eyes. The mean central foveal thickness determined with OCT was the least in the no leakage group and was increased in the order of the focal ,diffuse and combined leakage groups .Statistical analysis revealed a signification difference between these groups: ANOVA; F=40; P＜0.05. The best-corrected visual acuity was significantly correlated with central foveal thickness (r=-0.568, p＜0.05).Conclusion: OCT provided objective documentation of foveal structural changes in eyes with diabetic retinopathy, particularly at observation to the variation such as foveal detachment, posterior hyaloidal traction and CME etc. OCT is especially sensitive in the early stages of maculopathy when the structural changes are not yet evident at FA or the clinical examination with +90D noncontact lens. But OCT can't displace the role that FA has play in diagnosis of macular edema. FA was known to be a sensitive method for the qualitative assessment of fluid leakage in diabetic macular edema, which was inability to OCT. the clinical examination that the slit-lamp biomicoscopy with a +90D noncontact lens were cheap, easy and convenience. The combination OCT, clinical and FA can provide information that may be useful to disclose the pathogenesis of the edema, diagnosis and optimize the treatment for eath type.