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The relationship between foveal ischemia and spectral-domain optical coherence tomography findings in ischemic diabetic macular edema.
Invest Ophthalmol Vis Sci. 2013 Feb 07; 54(2):1080-5.IO

Abstract

PURPOSE

To investigate the relationship between enlargement of the foveal avascular zone (FAZ) and structural changes on spectral-domain optical coherence tomography (SD-OCT) in patients with ischemic diabetic macular edema (DME).

METHODS

This was a retrospective, cross-sectional study including 35 eyes of 33 patients with ischemic DME as determined by irregular margins of the FAZ in fluorescein angiography. We measured the best-corrected visual acuity (BCVA), central subfield thickness (CST), subfield volume, subfoveal choroidal thickness, length of the photoreceptor outer segment (PR-OS), and the lateral extent of inner segment-outer segment (IS-OS) disruption on SD-OCT images, as well as the FAZ to optic nerve head (FAZ/ONH) area ratio by using the ImageJ program.

RESULTS

The mean FAZ/ONH area ratio was 0.28 ± 0.15. The FAZ/ONH area ratio was positively correlated with the logarithm of the minimum angle of resolution (LogMAR) BCVA (P = 0.001, r = 0.529). The mean CST was 391 ± 110 μm, and the subfield volume was 0.31 ± 0.09 mm(3). The mean length of the PR-OS and the horizontal and vertical extent of IS-OS disruption were 40 ± 8 μm, 169 ± 294 μm, and 114 ± 170 μm, respectively. The mean length of the PR-OS and the horizontal and vertical extent of IS-OS disruption were significantly correlated with FAZ/ONH area ratio (P = 0.020, P = 0.001, and P = 0.049, respectively). The horizontal and vertical extent of IS-OS disruption showed a positive correlation with LogMAR BCVA (P = 0.027 and P = 0.049, respectively).

CONCLUSIONS

Foveal ischemia in DME appears to cause PR-OS shortening and IS-OS disruption resulting in outer retinal layer atrophic changes and subsequent visual loss.

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Publisher Full Text

Authors+Show Affiliations

Lee DH
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kim JT
No affiliation info available
Jung DW
No affiliation info available
Joe SG
No affiliation info available
Yoon YH
No affiliation info available

MeSH

AdultAgedChoroidCross-Sectional StudiesDiabetic RetinopathyFemaleFluorescein AngiographyFovea CentralisHumansIschemiaMacular EdemaMaleMiddle AgedOptic DiskRetinal Photoreceptor Cell Inner SegmentRetinal Photoreceptor Cell Outer SegmentRetrospective StudiesTomography, Optical CoherenceVisual AcuityYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23329668

Citation

Lee, Dong-Hoon, et al. "The Relationship Between Foveal Ischemia and Spectral-domain Optical Coherence Tomography Findings in Ischemic Diabetic Macular Edema." Investigative Ophthalmology & Visual Science, vol. 54, no. 2, 2013, pp. 1080-5.
Lee DH, Kim JT, Jung DW, et al. The relationship between foveal ischemia and spectral-domain optical coherence tomography findings in ischemic diabetic macular edema. Invest Ophthalmol Vis Sci. 2013;54(2):1080-5.
Lee, D. H., Kim, J. T., Jung, D. W., Joe, S. G., & Yoon, Y. H. (2013). The relationship between foveal ischemia and spectral-domain optical coherence tomography findings in ischemic diabetic macular edema. Investigative Ophthalmology & Visual Science, 54(2), 1080-5. https://doi.org/10.1167/iovs.12-10503
Lee DH, et al. The Relationship Between Foveal Ischemia and Spectral-domain Optical Coherence Tomography Findings in Ischemic Diabetic Macular Edema. Invest Ophthalmol Vis Sci. 2013 Feb 7;54(2):1080-5. PubMed PMID: 23329668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The relationship between foveal ischemia and spectral-domain optical coherence tomography findings in ischemic diabetic macular edema. AU - Lee,Dong-Hoon, AU - Kim,Jee Taek, AU - Jung,Da-Woon, AU - Joe,Soo Geun, AU - Yoon,Young Hee, Y1 - 2013/02/07/ PY - 2013/1/19/entrez PY - 2013/1/19/pubmed PY - 2013/4/25/medline SP - 1080 EP - 5 JF - Investigative ophthalmology & visual science JO - Invest Ophthalmol Vis Sci VL - 54 IS - 2 N2 - PURPOSE: To investigate the relationship between enlargement of the foveal avascular zone (FAZ) and structural changes on spectral-domain optical coherence tomography (SD-OCT) in patients with ischemic diabetic macular edema (DME). METHODS: This was a retrospective, cross-sectional study including 35 eyes of 33 patients with ischemic DME as determined by irregular margins of the FAZ in fluorescein angiography. We measured the best-corrected visual acuity (BCVA), central subfield thickness (CST), subfield volume, subfoveal choroidal thickness, length of the photoreceptor outer segment (PR-OS), and the lateral extent of inner segment-outer segment (IS-OS) disruption on SD-OCT images, as well as the FAZ to optic nerve head (FAZ/ONH) area ratio by using the ImageJ program. RESULTS: The mean FAZ/ONH area ratio was 0.28 ± 0.15. The FAZ/ONH area ratio was positively correlated with the logarithm of the minimum angle of resolution (LogMAR) BCVA (P = 0.001, r = 0.529). The mean CST was 391 ± 110 μm, and the subfield volume was 0.31 ± 0.09 mm(3). The mean length of the PR-OS and the horizontal and vertical extent of IS-OS disruption were 40 ± 8 μm, 169 ± 294 μm, and 114 ± 170 μm, respectively. The mean length of the PR-OS and the horizontal and vertical extent of IS-OS disruption were significantly correlated with FAZ/ONH area ratio (P = 0.020, P = 0.001, and P = 0.049, respectively). The horizontal and vertical extent of IS-OS disruption showed a positive correlation with LogMAR BCVA (P = 0.027 and P = 0.049, respectively). CONCLUSIONS: Foveal ischemia in DME appears to cause PR-OS shortening and IS-OS disruption resulting in outer retinal layer atrophic changes and subsequent visual loss. SN - 1552-5783 UR - https://www.unboundmedicine.com/medline/citation/23329668/The_relationship_between_foveal_ischemia_and_spectral_domain_optical_coherence_tomography_findings_in_ischemic_diabetic_macular_edema_ L2 - https://iovs.arvojournals.org/article.aspx?doi=10.1167/iovs.12-10503 DB - PRIME DP - Unbound Medicine ER -