Diabetic macular edema: an OCT-based classification

Abstract

Although ETDRS guidelines for laser treatment of DME still remain the only proven therapy for this condition, many other strategies are now on trial, and the vast majority of authors use OCT as the best indicator of therapeutic benefit. The amount of information given by OCT demonstrates that macular edema is a complex clinical entity with various morphology and gravity, and disclaimed the limitations of a simple "clinical" definition. As in many other examples such as macular holes and choroidal neovascularization, a uniform and precise definition of macular edema would increase the possibility to compare and judge the result of different therapeutic strategies. Aim of this classification is to implement the ETDRS clinical definition of DME with the precise and useful data given by OCT to better diagnose, catalogue and follow macular edema.

Optical Coherence Tomography Patterns in Diabetic Macular Edema can Predict the Effectiveness of Intravitreal Bevacizumab Combined with Macular Photocoagulation

“…Today there are several classifications of DME according to the OCT criteria [18][19][20]. This particular study uses the classification of Otani, according to which nontractional DME is three types: DRT, CME and SRD [18].…”

Classification of diabetic retinopathy and diabetic macular edema

“…These patterns are not exclusive of each other and may co-exist with one another. Despite attempts to implement an OCT-based classification of DME [24] , there has been no consensus on its use. A Cochrane review concluded that there is substantial disagreement between the OCT findings and CSME as defined by clinical examination [25] .…”

Optical Coherence Tomography Findings in Diabetic Macular Edema

“…In eyes with macular edema the pattern of SMD may also be found (Alkuraya et al, 2005;Catier et al, 2005;Kaiser et al, 2001;Kim et al, 2006;Koleva-Georgieva & Sivkova, 2009;Otani et al, 1999;Panozzo et al 2004). This feature can be detected "in vivo" only by means of OCT, as it does not show on ophthalmoscopy or fluorescein angiography.…”

“…Other published classifications are presented by several authors (Kang et al, 2004;Kim et al, 2006;Panozzo et al, 2004). We propose and use in our clinical practice a classification, which summarizes several quantitative and qualitative OCT data: retinal thickness, retinal morphology, retinal topography, macular traction and foveal photoreceptor status.…”

“…The role of this type of incomplete PVD in the pathogenesis of macular edema is not fully understood. Several studies have classified the incomplete PVD in order to define its relation with macular edema (Gaucher et al, 2005;Koizumi et al, 2008;Panozzo et al, 2004). (Gaucher et al, 2005).…”