Correlation between intraretinal changes in diabetic macular oedema seen in fluorescein angiography and optical coherence tomography

Abstract

ABSTRACT.Purpose: To study the relationship between intraretinal optical coherence tomography (OCT) and fluorescein angiography (FA) findings in eyes with diabetic macular oedema (DMO). Methods: We carried out a retrospective observational case series. Thirty eyes with previously untreated DMO underwent FA and OCT. The same ETDRS template was overlaid on the FA images in order to compare OCT and FA. Transfoveal linear high-resolution OCT scans (at the 0-and 90-degree meridians) and FA pictures were compared according to the ETDRS rings. Results: Six distinct patterns of intraretinal changes in OCT correlated with changes in FA: (a) focal angiographic leakage did not correspond to any obvious intraretinal abnormality in OCT in four eyes; (b) localized thickening of the outer nuclear layer in OCT corresponded to focal leaking microaneurysm (focal oedema) in FA in 11 eyes; (c) diffuse thickening of the outer nuclear layer in OCT corresponded to diffuse angiographic leakage in 21 eyes; (d) cystoid expansion of the outer nuclear layer was found in seven eyes with a petaloid angiographic pattern of leakage; (e) cystoid expansion of the inner nuclear layer was found in relation to honeycomb angiographic oedema in five eyes, and (f) serous detachment of the fovea in OCT did not correspond to any distinct finding in FA in four eyes. Conclusions: Intraretinal abnormalities found in OCT correlate systemically with changes in FA. Very early DMO morphological changes may be seen better with FA than with OCT. Serous detachment of the fovea is seen in OCT, but not in FA. The combination of OCT and FA is useful in facilitating understanding of the pathophysiological changes that occur in DMO.

Indocyanine Green Angiography-Guided Focal Laser Photocoagulation for Diabetic Macular Edema

“…1, 2b, 7). OCT can provide helpful information for FA-guided grid laser photocoagulation to treat DME [30,31,32,33]. In contrast, OCT may be more useful for detecting responsible focal leakage points by ICGA-guided laser photocoagulation.…”

Ocular Phenotype Analysis of a Family With Biallelic Mutations in the BEST1 Gene

“…However, the inner nuclear layer is a locus for edema in conditions with different pathophysiology, such as vascular leakage and breakdown of the inner blood retina barrier as in diabetic macular edema and in multiple sclerosis. 28,29 The plexiform layers surrounding the inner nuclear layer contain networks of microglia that seem to form a diffusion barrier. There may also be a primary involvement of Müller glia in the genesis of the inner nuclear layer edema in multiple sclerosis, 29 and by analogy it is tempting to speculate that Bestrophin may be expressed in the inner retina and that a failure of potassium and chloride transport across the cell membrane results in edema in this retinal layer in autosomal recessive bestrophinopathy.…”

RPE barrier breakdown in diabetic retinopathy: seeing is believing

“…The development of OCT technology has largely enhanced our ability to perform diagnosis for DR patients, particularly for those with macular edema. A combination of OCT with fluorescent angiography is more advantageous for the classification of DR patients [76]. While OCT is a diagnostic tool for lesions, it is not ideal for the measurement of RPE barrier leakage.…”