The Correlation Of Macular Morphology And Function In Patients With Diabetic Macular Edema

Chapter 1:Correlation of retinal sensitivity,visual acuity and central retinal thickness in diabetic macular edemaAim To investigate the correlation of retinal sensitivity,acuity and central retinal thickness in diabetic macular edema,and explore the relationship between the integrity of ellipsoidal zone and visual acuity.Methods A retrospectives study.45 eyes of 30 patients in diabetic macular edema(DME)were included.Visual acuity were examined with best-corrected visual acuity(BCVA),BCVA was examined with interaction visual chart and recorded with logarithm of the minimum angle of resolution acuity.The following parameters provided by the MAIA microperimetric divice were evaluated:average threshold(AT),fixation indexes(P1 and P2),bivariate contour ellipse area(BCEA)for 63%and 95%of points(BCEA63,BCEA95).To analyze the correlation of AT,P1,P2,BCEA63,BCEA95 and logMAR BCVA in patients with DME.OCT was used to measure the central macular thinkness.The integrity of the ellipsoid zone was observed by OCT and divided into three groups:the ellipsoid band was completely visible,partially visible and completely invisible,and the difference between the three groups was analyzed.Result The correlation analysis showed:logMAR BCVA was positively correlated with central retinal thickness(CRT)(r=0.342,P=0.02),negatively correlated with AT(r=-0.59,P=0.00)?P1(r=-0.38,P=0.01).The result of multivariate linear regression analysis showed that logMAR BCVA was inversely correlated with AT(t=-3.53,P=0.001).In 45 eyes,the distribution of the integrity of the ellipsoidal band was completely visible in 23 eyes,partially visible in 17 eyes,and completely invisible in 5 eyes.Differences in logMAR BCVA,AT,and CRT between the three groups were statistically significant(P=0.045,0.049,0.018).Conclusions Microperimetry combined with OCT and visual acuity can be used to assess the visual function of patients with DME.In the patients of DME logMAR BCVA was positively correlated with CRT,negatively correlated with AT and P1.LogMAR BCVA is an independent factor affecting AT.The integrity of ellipsoidal zone is related to logMAR BCVA?AT and CRT.Chapter 2 The evalution of the macular function of dabetic macular edema by microperimetryObjective To evaluate the visual function of diabetic macular edema(DME)patients by microperimetry.Methods A retrospective case series study.164 cases(220eyes)with clinical diagnosis of DME were examined for MAIA microperimetry and best corrected visual acuity(BCVA).According to the fixation rate,the subjects were divided into 3 groups:stable fixation,relative unstable fixation and unstable fixation.According to the difference of retinal sensitivity,3 stages of fixation stability were divided:normal groups,suspicious groups and abnormal groups.The following parameters provided by the MAIA divice were evaluated:average threshold(AT),2 degree fixation rate(P1),4 degree fixation rate(P2)and bivariate contour ellipse area(BCEA)for 63%and 95%of points(BCEA63,BCEA95).The best corrected visual acuity(BCVA)were recorded as logarithm of resolution(logMAR).Variables related with AT and logMAR BCVA were analyzed in the different fixation stability.LogMAR BCVA was analyzed in the three groups of normal,suspicious and abnormal.To analyze the correlation of AT,P1,P2,BCEA63,BCEA95 and logMAR BCVA in patients with DME.Results Comparison between different fixation stability of DME patients showed statistically significant differences in mean AT and mean logMAR BCVA(all P<0.05).There were statistically significant differences in mean AT and mean logMAR BCVA between stable group and unstable group,relatively stable group and unstable group(all P<0.05).There were statistically significant differences in mean logMAR BCVA between the three groups of A1,A2 and A3(P<0.05)in the stable group.There were statistically significant differences in any of the two groups between the three groups.In the patients of DME,logMAR BCVA was negatively correlated with AT,P1 and P2(r=-0.712,P=0.000;r=-0.380,P=0.000;r=-0.370,P=0.000),and positively correlated with BCEA63 and BCEA95(r=0.352,P=0.000;r=0.376,P=0.000).AT was positively correlated with P1,P2(r=0.304,P=0.000;r=-0.280,P=0.000),and negatively correlated with BCEA63 and BCEA95(r=-0.291,P=0.000;r=-0.354,P=0.000).Multiple linear regression analysis showed that logMAR BCVA was independently affected by AT and P1(t=-13.32,P=0.000;t=-3.54,P=0.000).Conclusions There were significant differences in visual acuity and retinal sensitivity in DME patients with different fixation stability;in DME patients,although the fixation was the same,the retinal sensitivity remained quite different.The MAIA microperimeter can assess macular visual function in patients with DME.AT,P1 and logMAR BCVA can be used as a good index to evaluate the macular visual function and can accurately reflect the visual function status of DME patients.Provides a good reference for clinicians in the treatment of DME patients.