Abstract

P 261

Diabetic maculopathy: Evaluation of relation between morphology and function using spectral domain OCT and fundus related microperimetry

Wiebke Krüger, Andreas Henschel, Matthias Gutfleisch, Albrecht Lommatzsch, Daniel Pauleikoff, Georg Spital
Augenabteilung am St. Franziskus Hospital, Münster

Objective
high resulution spectral domain OCT (sdOCT) allows a microstructural in vivo analysis of retinal lesions. This study is taking a closer look at the effects of various retinal lesions in different stages of diabetic macular edema (DME) on retinal function measured by fundus related microperimetry (MP-1, Nidek).
Methods
Using combined FLA and sdOCT technique (Spectralis, HE) an exactly localized retinal layer imaging was performed. The amount and localisation of different diabetic retinal lesion was measured. The local distribution was assessed using a retinal grid in accordance to ETDRS. The findings were correlated to visual acuity, retinal sensitivity and fixation pattern as analysed with microperimetry.
Results
In 40 eyes of 25 patients (age 35-71y, mean duration of diabetes 13y) with minimal (few microaneurysms) to pronounced diabetic maculopathy (clinically significant focal/diffuse ME) and different stages of retinal cyst formation and lipid exudation we found the following correlations: Local retinal thickness corresponded with few exceptions to a relative drop in retinal sensitivity in the respective field. Formation of cysts only lowered local sensitivity when several retinal layers were concerned. The amount of lipid exudation was associated to lowered sensitivity, which was true for pronounced exudations even after their clinical disappearance. Massive lowering in retinal sensitivity was observed in areas of retinal photocoagulation. Even if laser scars were clinically unremarkable retinal sensitivity was almost extinct. Stability of fixation was poorly correlated to visual acuity and central OCT thickness.
Conclusions
The different macular lesions observed in diabetic retinopathy can be monitored well using sdOCT. Besides the quantification of retinal thickness a lesion specific retinal analysis can be performed. In correlation with microperimetry differences in retinal sensitivity and fixation pattern can be measured in dependence of type, amount and distribution of different diabetic macular lesions.

Copyright: 2009 Porstmann Kongresse GmbH. All rights reserved. Impressum, Disclaimer.