Association between photoreceptor integrity and visual outcome in diabetic macular edema

Shin, Hyun Jin; Lee, Seung Hyen; Chung, Hyewon; Kim, Hyung Chan

doi:10.1007/s00417-011-1774-x

Cited by 169 publications

(128 citation statements)

References 43 publications

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“…In a previous study, ischemic retina was correlated with outer retinal thinning. 7 Photoreceptor integrity and thickness are also good predictors of the visual outcome in patients with DME, 6,19,20 although the mechanism of photoreceptor damage in DME is still not clearly understood. A recent study suggested several possible mechanisms: extravasated blood constituents and inflammatory cells, which might exacerbate the macular structure; subretinal fluid, which might decrease the metabolism of photoreceptor cells; and extended cystoid spaces, which might lead to retrograde degeneration of photoreceptor cells.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Foveal Ischemia and Spectral-Domain Optical Coherence Tomography Findings in Ischemic Diabetic Macular Edema

Lee¹,

Kim²,

Jung³

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate the relationship between enlargement of the foveal avascular zone (FAZ) and structural changes on spectral-domain optical coherence tomography (SD-OCT) in patients with ischemic diabetic macular edema (DME).METHODS. This was a retrospective, cross-sectional study including 35 eyes of 33 patients with ischemic DME as determined by irregular margins of the FAZ in fluorescein angiography. We measured the best-corrected visual acuity (BCVA), central subfield thickness (CST), subfield volume, subfoveal choroidal thickness, length of the photoreceptor outer segment (PR-OS), and the lateral extent of inner segment-outer segment (IS-OS) disruption on SD-OCT images, as well as the FAZ to optic nerve head (FAZ/ONH) area ratio by using the ImageJ program. RESULTS.The mean FAZ/ONH area ratio was 0.28 6 0.15. The FAZ/ONH area ratio was positively correlated with the logarithm of the minimum angle of resolution (LogMAR) BCVA (P ¼ 0.001, r ¼ 0.529). The mean CST was 391 6 110 lm, and the subfield volume was 0.31 6 0.09 mm 3 . The mean length of the PR-OS and the horizontal and vertical extent of IS-OS disruption were 40 6 8 lm, 169 6 294 lm, and 114 6 170 lm, respectively. The mean length of the PR-OS and the horizontal and vertical extent of IS-OS disruption were significantly correlated with FAZ/ONH area ratio (P ¼ 0.020, P ¼ 0.001, and P ¼ 0.049, respectively). The horizontal and vertical extent of IS-OS disruption showed a positive correlation with LogMAR BCVA (P ¼ 0.027 and P ¼ 0.049, respectively).CONCLUSIONS. Foveal ischemia in DME appears to cause PR-OS shortening and IS-OS disruption resulting in outer retinal layer atrophic changes and subsequent visual loss. (Invest Ophthalmol Vis Sci. 2013;54:1080-1085) DOI:10.1167/iovs.12-10503 D iabetic macular edema (DME) is a leading cause of visual loss in diabetes patients. 1 In diabetic retinopathy, enlargement of the foveal avascular zone (FAZ) is often detected by fluorescein angiography (FA). 2 FAZ enlargement is considered an indication of ischemia and may contribute to macular edema. 3 Macular ischemia is also known to be associated with poor visual outcome in diabetic patients regardless of their treatment. 4,5 Recent technological advances in imaging have made it possible to analyze morphological changes of the retina in various retinal diseases. Optical coherence tomography (OCT) is an important tool being used to evaluate the retinal status and to predict the visual outcome. Several studies have investigated the correlation between structural changes in OCT and the visual prognosis in diabetic patients with macular edema.6-8 Spectral-domain OCT (SD-OCT) is the most recently developed type of OCT and provides high-resolution images with an axial resolution of <5 lm. SD-OCT therefore provides clearer structural information regarding the retina and helps to identify the pathologic mechanisms in various retinal diseases. 9-10The purpose of this study was to investigate the relationship between enlargement of the FAZ and structural changes in SD-O...

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Section: Discussionmentioning

confidence: 99%

The Relationship between Foveal Ischemia and Spectral-Domain Optical Coherence Tomography Findings in Ischemic Diabetic Macular Edema

Lee¹,

Kim²,

Jung³

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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“…OCT allows quantitative measurements of retinal thickness, as well as evaluation of morphologic changes in eyes with DR and DME. Potential neuroretinal biomarkers of visual acuity in eyes with DME based on OCT imaging have been suggested, including ganglion cell layer thinning, disorganization of the retinal inner layers, and photoreceptor disruption, although further validation is needed (44)(45)(46)(47). Recently, the technique of OCT angiography has also been utilized to create high-resolution perfusion maps of the central retinal vasculature (48).…”

Section: Evaluating the Diabetic Retinamentioning

confidence: 99%

Diabetic retinopathy: current understanding, mechanisms, and treatment strategies

Duh¹,

Sun²,

Stitt³

2017

JCI Insight

720

648

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“…Birçok retinal hastalıkta IS/OS bandında bozulmanın düşük görme keskinliği ile korele olduğu gösterilmiş-tir. Retinal ven dal tıkanıklığında diabetik retinopatide görsel prognozla ilişkili olduğu bildirilmiştir [13][14][15]. Yalçınbayır ve ark.…”

Section: Discussionunclassified

Spectral domain optical coherence tomography findings of the patients with central serous chorioretinopathy

Yüksel

Türkçü²,

Şahin³

et al. 2014

J Clin Exp Invest

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Objective: In this study, optical coherence tomography (OCT) findings of the patients with a diagnosis of acute or chronic central serous chorioretinopathy (CSCR) were investigated. Methods:Patients with symptoms and signs longer than 3 months were considered as chronic CSCR. OCT findings of acute and chronic CSCR were recorded at admission. Between the groups, following parameters were compared; visual acuity, hyper reflective dots (HRD), subretinal fluid height (SFH) presence of pigment epithelial detachment (PED), status of photoreceptor inner-outer segment (IS/OS) line.Results: When acute and chronic patients evaluated separately, in acute patients accompanied by PED had lower visual acuity and higher SRF height. In patients with chronic CSCR subretinal fluid of patients with PED was greater than the others however there were no statistically significant differences in visual acuity. Presence of HRD had no effect on the average visual acuity SRF height in patients with acute and chronic CSCR. Also IS/OS line integrity had no effect in visual acuity of the patients in our study. Conclusion:Between the groups there was no difference in terms of IS/OS line distortion, presence of HRD, PED. Height of SRF in patients with PED was higher in both groups. In addition, in acute patients with PED visual acuity was also found to be lower. J Clin Exp Invest 2014; 5 (2): 290-293

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Association between photoreceptor integrity and visual outcome in diabetic macular edema

Abstract: IS/OS and ELM are useful hallmarks for use in evaluation of foveal photoreceptor layer integrity, and are closely associated with final VA in DME. Pretreatment VA and photoreceptor status can predict potential restoration of photoreceptor integrity and subsequent visual recovery in DME.

Cited by 169 publications

References 43 publications

The Relationship between Foveal Ischemia and Spectral-Domain Optical Coherence Tomography Findings in Ischemic Diabetic Macular Edema

The Relationship between Foveal Ischemia and Spectral-Domain Optical Coherence Tomography Findings in Ischemic Diabetic Macular Edema

Diabetic retinopathy: current understanding, mechanisms, and treatment strategies

Spectral domain optical coherence tomography findings of the patients with central serous chorioretinopathy

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