Fundus autofluorescence in the assessment of diabetic macular edema

Abstract

Objective: To assess the association between fundus autofluorescence (FAF) and optical coherence tomography (OCT) and fluorescein angiography (FA) parameters in patients with diabetic macular edema (DME). Methods: Study design: non-comparative case series. Thirty-seven eyes of 20 patients with DME were included. Patients underwent best-corrected visual acuity and contrast sensitivity determination, assessment of central subfield thickness (CST), macular volume (MV), and macular cube average thickness (MCAT) by spectral-domain OCT, as well as FAF and FA imaging. SD-OCT EMD and foveal FAF patterns (decreased, normal, increased single-spot, and increased multiple-spot) were evaluated. Fisher exact test, interobserver variability, and Kruskall-Wallis test were used for statistical analysis. Results: A statistically significant difference was observed between the four FAF foveal patterns in the MV (p = 0.03), and in the MCAT groups (p = 0.01). Post-hoc analysis with the U-Mann-Whitney test showed a statistically significant difference between decreased FAF and normal FAF patterns, and between decreased FAF and increased multiple-spot FAF patterns (p < 0.05) in the MV and MCAT groups. Foveal capillary leakage by FA was observed in a higher proportion of eyes in the increased single-spot and multiple-spot FAF patterns (p = 0.03). Conclusions: Flash camera FAF shows changes regarding MV, MCAT, and the presence of foveal capillary leakage in patients with DME. It is relevant to establish the value of FAF in the assessment of DME.