Optical coherence tomographic patterns in diabetic macular oedema: prediction of visual outcome after focal laser photocoagulation

Abstract

DRT patients achieved a greater reduction in retinal thickening and greater VA increases than CMO and VMIA patients. We suggest that classifying DMO structural patterns using OCT might allow visual outcome to be predicted after laser photocoagulation.

Qualitative and quantitative OCT response of diffuse diabetic macular oedema to macular laser photocoagulation

“…Although SRD is often considered a poor prognostic indicator in DMO, previous studies on the prognostic value of SRD in DMO have reported conflicting observations. 4,31 Localised macular oedema (less than four parafoveal quadrants) responded better to grid laser than when all four quadrants were involved, supporting a previous study. 8 Our study also showed that eyes with moderate AMT of 300-350 mm had the worse response to laser, unlike the findings noted by Estabrook et al 32 We hypothesise that moderate thickening do not benefit from a quick response compared with those with o300 mm oedema and those with severe oedema of 4350 mm thickening.…”

“…The most favourable outcome was noted with the DRT group, whereas CMO were poor responders. Similar results have been obtained with other forms of therapies for DMO, 4,[25][26][27] suggesting that the vertical cell-cell alignment of the retinal layers is crucial for positive outcomes to any form of therapeutic intervention. In fact, a recent study showed that the cross-sectional area of retinal tissue between the plexiform layers in CMO on OCT is the best indicator of visual function.…”

“…3 So, the Diabetic Retinopathy Clinical Research Network (http://DRCR.net) investigators concluded that new classifications that better characterises the response to treatment are required. 3 With the advent of optical coherence tomography (OCT), several investigators have classified DMO on the basis of the retinal map and cross-sectional appearance of the retina on OCT. 4,5 The spectral domain OCT allows better characterisation of the retinal morphology. The morphological patterns of DMO on OCT are generally classified into diffuse retinal thickening (DRT), cystoid macular oedema (CMO), subretinal detachment (SRD), and vitreomacular interface abnormalities.…”

“…The morphological patterns of DMO on OCT are generally classified into diffuse retinal thickening (DRT), cystoid macular oedema (CMO), subretinal detachment (SRD), and vitreomacular interface abnormalities. [4][5][6][7] Similarly, DMO has been classified on the basis of the area of retinal thickness on the retinal thickness map into diffuse parafoveal thickening defined as having all four parafoveal OCT quadrants greater than 300 mm and focal oedema when fewer than four quadrants are greater than 300 mm. 8 In clinical trials, a central macular thickness of 300 mm on Stratus OCT is often taken as the cutoff point to diagnose DMO.…”

Effect of a single intravitreal bevacizumab injection on different optical coherence tomographic patterns of diabetic macular oedema

“…Kim et al 13 have asked the question whether specific OCT patterns were predictive of visual outcome after focal laser photocoagulation in DMO. They have concluded that DRT pattern was associated with a greater reduction in retinal thickening and better visual acuity improvement compared with CMO pattern.…”