الفهرس | Only 14 pages are availabe for public view |
Abstract DME remains one of the most common ocular complications of DM which is expected to be prevalent among 10.4% of world population by 2040. (Javadi MA, 2008 and Nam HC et al, 2015) In addition, over one million cataract surgeries performed each year, PCME remains the most frequent cause of limited visual recovery (Rosetti L, 2000) The curability and selection of management lines of ME with its diverse etiologies, are affected by the underlying pathology. (Endo N et al, 2010, Faghihi F et al, 2017 and Soheilian M et al, 2010) This study aimed to use OCT in clarifying the morphological differences between DME and PCME. It included 50 eyes of 43 patients divided in two groups (30 eyes with DME and 20 with PCME). A SD-OCT was used to examine the macula in both groups. Tomographic features were analyzed and differentiation criteria were evaluated in both groups. According to the results of this study, DME can be differentiated from PCME using SD-OCT. The differentiation is possible depending on the following features: the distribution of cystic changes when it involves the inner retina (mainly GCL and RNFL), it suggests DME. The relative affinity of INL to cystic changes compared to other retinal layers suggests PCME. The presence of ERM suggest DME whereas the absence of inner retinal cystic changes with a dome-shaped foveal contour and a high T/V ratio with SRF collection are the most statistically significant diagnostic criteria that strongly suggest PCME over DME. The following table summarizes the most important differentiation criteria: Table 12: Important differentiation criteria in both categoriesDME PCME Presence of cystic changes in the inner retina (mainly GCL and RNFL) Absence of inner retinal cystic changes The relative affinity of INL to cystic changes compared to other retinal layers low T/V ratio High T/V ratio Presence of other contour morphologies Dome-shaped foveal contour Presence of ERM Presence of SRF collection The efficacy of OCT in such a differentiation shall positively affect the management strategy. It also makes OCT, with its previously mentioned advantages, superior over other invasive investigative tools in such differentiation. It might be particularly valuable in diabetic patients who were found to have ME after a recent cataract surgery because neither the clinical assessment nor the other diagnostic tools can rule out the underlying pathology. |