Serous macular detachment in central retinal vein occlusion

PURPOSE: To describe serous macular detachment in patients with central retinal vein occlusion (CRVO) by using optical coherence tomography (OCT). METHODS: This study included 22 eyes of 22 consecutive patients with CRVO. The patients underwent complete ophthalmic examination, including corrected visual acuity measurement, slit-lamp biomicroscopy, indirect ophthalmoscopy, color fundus photography, fluorescein angiography, and OCT. RESULTS: Twenty-two patients (22 eyes) with cystoid macular edema associated with CRVO (10 women and 12 men; age range, 48-75 years [average, 62.5 years]) made up the study population. Angiographically, all patients had typical cystoid macular edema. At the time of initial examination, no patient was suspected of having a serous macular detachment associated with CRVO. The mean foveal thickness as determined by OCT was 567.4 microm. In all cases, the increased thickness of the retina was related primarily to the hyporeflective intraretinal cavities. A serous macular detachment composed of retinal elevation over a nonreflective cavity with minimal shadowing of the underlying tissues was seen in 18 eyes (81.8%). CONCLUSION: OCT findings in this study showed that serous macular detachment in patients with CRVO occurs more often than previously thought. Our data also showed that noncontact fundus ophthalmoscopy and fluorescein angiography were not sufficient to diagnose serous macular detachment in CRVO.     

Macular traction detachment and diabetic macular edema associated with posterior hyaloidal traction

PURPOSE: To review the clinical, photographic, fluorescein angiographic, and optical coherence tomographic findings in patients with the diabetic macular traction and edema (DMTE) associated with posterior hyaloidal traction (PHT). METHODS: We performed a prospective review of nine eyes of nine patients with diabetic macular edema (DME) and PHT on clinical examination. The patients had a comprehensive ophthalmic history and examination, color photographs, fluorescein angiography, and optical coherence tomography (OCT). RESULTS: All patients had diabetic retinopathy and DME. Of the nine eyes, eight patients had previous focal or grid photocoagulation. All nine eyes had a thickened, taut, glistening posterior hyaloid on clinical biomicroscopic examination with no posterior vitreous separation. Fluorescein angiography was performed on seven eyes, and all had early hyperfluorescence with deep, diffuse, late leakage in the macular area consistent with DMTE associated with PHT. Optical coherence tomography scans of the macular region revealed retinal thickening in all eyes with a mean retinal thickness of 556.9 +/- 114.7 microns. In addition, eight of the nine eyes had a shallow macular traction detachment associated with PHT. CONCLUSION: Eyes with DME associated with PHT may have a shallow, subclinical, macular detachment. Optical coherence tomography may be useful in evaluating patients with DME to see if a macular detachment is present.     

The correlation between fluorescein angiographic and optical coherence tomographic features in clinically significant diabetic macular edema

PURPOSE: To assess the correlation between the features of optical coherence tomography (OCT) and fluorescein angiography in clinically significant diabetic macular edema. DESIGN: Retrospective observational case series. METHODS: This study involved 145 eyes (91 patients) with clinically significant diabetic macular edema. The fluorescein angiography features were categorized into focal leakage type, diffuse leakage type, and diffuse cystoid leakage type. The OCT features were categorized into four types: type 1, thickening with homogeneous optical reflectivity; type 2, thickening with markedly decreased optical reflectivity in the outer retinal layer; type 3A, foveolar detachment without traction; and type 3B, foveolar detachment with apparent vitreofoveal traction. The correlation between fluorescein angiography types and OCT types were analyzed, and their associations with visual acuity, central foveal thickness. and stages of diabetic retinopathy were evaluated. RESULTS: The prevalence of OCT type 1 was higher in the focal leakage type (73.0%) and in the diffuse leakage type (58.9%) than in the diffuse cystoid leakage type (3.8%) of fluorescein angiography (P <.0001). The prevalence of OCT type 2 and 3A was higher in the diffuse cystoid leakage type (57.7% and 34.6%, respectively) than in the focal leakage type (20.6% and 3.2%) or diffuse leakage type(28.6% and 10.7%; P <.0001). The stages of retinopathy correlated with fluorescein angiography types (P =.016). Optical coherence tomography type 1 and the focal leakage type of fluorescein angiography showed the least foveal thickness and the best visual acuity (P <.05). CONCLUSIONS: There was a significant correlation between the features of OCT and fluorescein angiography in clinically significant diabetic macular edema. The combined data from both OCT and fluorescein angiography may provide a clearer understanding of the anatomic and physiologic characteristics of clinically significant diabetic macular edema.     

Optical coherence tomographic assessment of diabetic macular edema: comparison with fluorescein angiographic and clinical findings

PURPOSE: To compare the optical coherence tomographic (OCT) features with clinical and fluorescein angiographic (FA) findings in patients with diabetic retinopathy. METHODS: In a retrospective study ophthalmologic examination together with FA and OCT images were obtained from 195 eyes of 110 patients with different stages of diabetic retinopathy and OCT images were obtained from 40 eyes of 20 control subjects. Fluorescein leakage characteristics were organized into five groups: no leakage (1), focal (2), diffuse (3), combined focal+diffuse leakage (4) and cystoid (5). The Pearson correlation test was used to test the correlation between visual acuity and central foveal thickness and ANOVA was used for the statistical comparison between the groups. RESULTS: The OCT images demonstrated retinal swelling in 66.1% of eyes, cystoid macular edema (CME) in 11.8% of eyes, serous foveal detachment + swelling in 6.2% of eyes, serous foveal detachment+swelling+CME in 3.6% of eyes and normal foveal structure in 12.3% of eyes. The best-corrected visual acuity was significantly correlated with central foveal thickness (r:-0.528, p<0.01). There was 77% agreement between clinical examination and OCT results. CME was detected with OCT in 15.4% of eyes in our study, 40% of which was not detected with slit-lamp biomicroscopy and 63.3% of which was not evident in FA. None of the serous foveal detachments could be detected during slit-lamp biomicroscopy or FA. CONCLUSIONS: OCT-3 provided objective documentation of foveal structural changes in eyes with diabetic retinopathy. Best-corrected visual acuity provided a significant correlation with the retinal thickness at the central fovea. These results indicate that OCT can facilitate deciding on the treatment protocol (surgical or medical) and follow-up of diabetic patients, which is especially important in the early stages of diabetic maculopathy when the structural changes are not yet evident with slit-lamp biomicroscopy or angiographically.     

Resolution of serous macular detachment after intravitreal triamcinolone acetonide treatment of patients with branch retinal vein occlusion

PURPOSE: To evaluate the effect of intravitreal triamcinolone acetonide on serous macular detachment in patients with branch retinal vein occlusion (BRVO). METHODS: Eight eyes of 8 patients with BRVO (6 men and 2 women; age range, 52-76 years) made up the study population. The eligibility criteria for this study included clinically and angiographically detectable cystoid macular edema (CME) in which the presence of serous macular detachment was documented by optical coherence tomography (OCT). After intravitreal injection of 0.1 mL (4 mg) of triamcinolone acetonide, the visual and anatomical responses were observed. RESULTS: In all eyes, after injection of triamcinolone acetonide, CME and serous macular detachment regressed. At 3 and 6 months, CME and serous macular detachment had recurred in 1 eye (12.5%) and 2 eyes (25%), respectively. Patients with recurrence were retreated. No eyes lost vision at 1 month, and all eyes showed improvement. At 3 months, no eyes had lost vision from baseline, and 7 eyes (87.5%) showed improvement. At 6 months, again no eyes had lost vision from baseline, and 7 eyes (87.5%) maintained improved visual acuity. CONCLUSIONS: The preliminary results of our study showed prompt resolution of serous macular detachment with corresponding improved visual acuity in patients with CME secondary to BRVO. Further study with longer follow-up and a larger series is warranted to assess the long-term efficacy and safety.     

Patterns of macular edema in patients with uveitis: qualitative and quantitative assessment using optical coherence tomography

PURPOSE: To describe the morphologic characteristics of uveitic macular edema by the use of optical coherence tomography (OCT) and to investigate the correlation between tomographic features and visual acuity (VA). DESIGN: Cross-sectional study. PARTICIPANTS: Seventy consecutive patients with uveitis in a university-based practice with a clinical diagnosis of macular edema in at least one eye. Inclusion criteria were: (1) verification of macular edema by OCT, (2) adequate media clarity for fundus visualization, and (3) absence of coexisting ocular disease limiting visual potential. METHODS: Complete ophthalmic examination: best-corrected Snellen VA, slit-lamp examination, fundus biomicroscopy, indirect ophthalmoscopy, and OCT. Fluorescein angiography was performed in selected cases. MAIN OUTCOME MEASURES: Best-corrected Snellen VA and tomographic features of the macula, including macular thickness measurement and correlation of macular thickness with VA. RESULTS: Eighty-four eyes of 60 patients met the inclusion criteria. The mean VA (Snellen test) was 20/36. There were 3 patterns of macular edema: diffuse macular edema (DME), cystoid macular edema (CME), and serous retinal detachment (RD). Serous retinal detachment was detected in 17 eyes (20.2%). Patients were classified into the following groups: DME (46 eyes, 54.8%), CME (21 eyes, 25%), DME and RD (5 eyes, 5.9%), CME and RD (12 eyes, 14.3%). Epiretinal membrane was detected by OCT in 34 eyes (40.5%). Eight eyes (9.5%) demonstrated vitreomacular traction. The mean retinal thickness at the central fovea was 333+/-171 microm (mean +/- standard deviation). Macular edema was located mainly in the outer retinal layers. Eyes with CME had significantly greater retinal thickness measurements than eyes with DME (P<0.001). Multivariate analysis revealed that VA was negatively correlated with increased macular thickness, presence of CME, and RD (P<0.05). CONCLUSIONS: Optical coherence tomography demonstrated 3 patterns of macular edema in patients with uveitis: DME, CME, and RD. Epiretinal membrane coexisted in a significant percentage of patients. In patients with uveitis with clear media, the morphologic features of macular edema and macular thickness correlated with VA.     

糖尿病性黄斑水肿的光学相干断层扫描与荧光血管造影图像的对比分析

目的对比分析糖尿病视网膜病变患者的光学相干断层扫描(optical coherence tomography,OCT)与荧光血管造影(fluorescein angiographic,FA)图像。方法回顾性分析不同阶段糖尿病视网膜病变70例患者95眼的OCT和FA图像。结果OCT图像显示视网膜水肿占70.5%,囊样黄斑水肿(cystoid macular edema,CME)占13.7%,浆液性黄斑脱离并发水肿占4.2%,浆液性黄斑脱离并发水肿和CME占2.1%,正常黄斑结构占9.5%。结论OCT为糖尿病视网膜病变黄斑结构的变化提供了依据,特别是对FA未能发现的早期黄斑结构改变的诊断具有重要意义。     

Serous macular detachment combined with branch retinal vein occlusion

PURPOSE: To report frequency, clinical characteristics, treatment, and the complications of branch retinal vein occlusion (BRVO) with serous macular detachment. PATIENTS AND METHODS: We retrospectively studied 22 eyes of 22 patients in 111 eyes with acute BRVO, whose eyes had serous macular detachment that was detected by optical coherence tomography (OCT). Fluorescein angiography was conducted in 19 of the 22 eyes. Fourteen of the 22 eyes underwent scatter laser photocoagulation of the BRVO area. We observed serial OCT findings before and after treatment. RESULTS: Approximately 20% of the BRVO eyes had serous macular detachment. The superotemporal vein was occluded in 15 eyes and the inferotemporal vein was involved in 7 eyes. Four eyes were ischemic and 15 eyes were not ischemic. Extensive dye leakage was observed in the BRVO area in all examined eyes (19 eyes). The occlusion area of perifoveal capillary network ranged from 5 to 60%, with an average of 40%. OCT demonstrated pure serous macular detachment in 13 eyes and the remaining 9 eyes had both serous macular detachment and cystoid macular edema(CME). The occlusion area of perifoveal capillaries in these 9 eyes was more than 20%. Serous macular detachment was resolved in 11 of 14 eyes (80%) 6 months after laser treatment. The average period for resolution of macular detachment was 3.4 months after treatment. Visual acuity was improved more than 2 lines in 8 of the treated 11 eyes (73%). Hard exudates appeared in the posterior fundus in 13 of 14 treated eyes (93%) and in 16 of the total of 22 eyes (73%) in the follow-up period. Massive macular hard exudates and ensuing macular atrophy resulted in poor visual outcome. CONCLUSIONS: Serous macular detachment is one of the patterns of macular edema in BRVO. OCT is an essential tool to detect it. Leakage from the entire BRVO area seems to travel via subretinal space by gravity or other factors and may form serous detachment in the macular area. Laser photocoagulation is indicated for early resolution of serous macular detachment. The major complication of serous detachment is the deposit of macular hard exudates, which may result in poor visual outcome.     

50岁以上患者黄斑区视网膜浆液性色素上皮脱离的相干光断层扫描特征分析

目的 探讨50岁以上患者黄斑区视网膜浆液性色素上皮脱离(FED)的相干光断层扫描(OCT)图像特征.方法 回顾分析2003年6月至2007年8月50岁以上患者出现黄斑区浆液性PED的37例(50只眼)临床资料,患者均进行经黄斑区OCT检测,观察其图像特征,并结合眼底彩色照相、荧光素眼底血管造影(FFA),部分病例行吲哚菁绿血管造影(ICGA)检查结果 进行分析.结果 根据本文所选病例的OCT特征,将50岁以上患者出现黄斑区浆液性PED脱离分为3种:单纯性PED者14只眼(28%),玻璃膜疣样PED者26只眼(52%),合并神经上皮层脱离的PED者10只眼(20%).单纯性PED见于部分萎缩型年龄相关性黄斑变性(AMD)9只眼(18%)、特发性浆液性PED者5只眼(10%);玻璃膜疣样PED见于部分黄斑玻璃膜疣样病变26只眼(52%);合并神经上皮层脱离的FED见于部分复发性/迁延性中心性浆液性脉络膜视网膜病变(CSC)6只眼(12%)、视网膜下血管病变病例4只眼(8%).结论 50岁以上患者发生黄斑区浆液性PED可能是早期和基础性的老年性改变,其进一步的变化将导致脉络膜和视网膜的损害.OCT能够发现无明显临床症状的浆液性PED,清晰地显示PED形态,准确地测量PED范围,简化随访过程,有利于年龄相关性黄斑病变的早期诊断和治疗.     

渗出型老年黄斑变性患者眼底相干光断层成像结果分析

目的：了解渗出型老年黄斑变性（age-related macular degeneration,AMD）患者的眼底相干光断层成像（optical coherence tomography,OCT）特征。方法：对经常规检查、荧光素眼底血管造影（fundus fluorescein angiography,FFA）、吲哚青绿脉络血管造影（indocyanine green angiography,ICGA）确诊的渗出型AMD患者38例（42只眼）行眼底OCT检查,分析其图像资料,并与其FFA和ICGA检查结果进行比较。结果：OCT图像特征：典型纤维性新生血管膜34只眼,浆液性视网膜神经上皮脱离38只眼,视网膜神经纤维层脱离合并层间水肿8只眼,出血性和浆液性视网膜色素上皮（retinal pigment epithelium,RPE）脱离分别为11只眼和9只眼。结论：渗出型AMD患者眼底OCT图像特征为典型的纤维性新生血管膜合并浆液性视网膜神经上皮脱离、视网膜神经纤维层脱离、浆液性和出血性RPE脱离。上述图像特点证实和补充了FFA和ICGA检查结果,有助于渗出型AMD的诊断和评价。     

Optical coherence tomography study of tilted optic disk associated with macular detachment

Purpose To describe the macular findings by optical coherence tomography in both eyes of a patient with tilted optic disk and visual decrease. Methods A 35-year-old woman with bilateral tilted optic disk and serous macular detachment was examined by slit-lamp biomicroscopy, fluorescein angiography, indocyanine green angiography and optical coherence tomography (OCT). Results Fluorescein angiography demonstrated staining of the temporal rim of the staphyloma adjacent to the optic disk and hyperfluorescence of the diffuse pigmentary changes in the papillomacular area. Leakage points and serous macular detachment were not observed. The existing neurosensory detachment at the fovea became evident only by OCT. Conclusions The existence of subretinal fluid, which became evident only by OCT, supports the view that OCT could further contribute to the study of the asymptomatic pigmentary lesions of the macula that are present in 11% of eyes with tilted optic disk. The reason for the localized macular detachment remains unclear. Dysfunction of the retinal pigment epithelium (RPE) or leakage of the optic disk staphyloma rim could possibly explain the cause of fluid accumulation in the macula.     

视网膜中央静脉阻塞黄斑损害的两种影像检查的观察

目的探讨视网膜中央静脉阻塞(centralretinalveinocclusion,CRVO)所致黄斑损害的光学相干断层成像(opticalcoherencetomography,OCT)的图像特征与眼底荧光血管造影(fundusfluoresceinangiography,FFA)的关系。设计回顾性研究。研究对象33例33眼的视网膜中央静脉阻塞患者。方法对33例33眼的视网膜中央静脉阻塞患者进行OCT和FFA检查。采用OCT对黄斑水肿的高度进行了测量。结果4眼OCT表现为弥漫黄斑水肿,其FFA表现为黄斑拱环毛细血管轻度扩张渗漏;21眼OCT表现为黄斑囊样水肿,其FFA表现为13眼为典型的花瓣样黄斑囊样水肿,另8眼毛细血管扩张,拱环结构破坏,荧光素渗漏显著;3眼OCT表现为神经上皮脱离伴有黄斑水肿,其FFA表现为毛细血管扩张,荧光素渗漏;4眼OCT表现为视网膜内和/或视网膜下大量出血,其FFA检查表现为黄斑拱环破坏,结构不清,有出血遮挡;1眼OCT黄斑中心凹形态大致正常,其FFA检查表现为黄斑区荧光素轻度渗漏。结论OCT对于黄斑组织结构改变的敏感性优于FFA,并且能精确地分析和追踪观察黄斑水肿的病程演变。而FFA在OCT表现正常时,仍能反映出色素上皮屏障的破坏。因此,OCT和FFA两种检查各有优缺点,同时采用可更加全面地了解CRVO所致黄斑损害情况。     

45岁以上黄斑区神经上皮脱离患者疾病类型分析

目的 观察45岁以上患者发生黄斑区浆液性神经上皮脱离的疾病类型,探讨疾病诊断必要的辅助检查方法.方法 对年龄在45岁以上,双目间接检眼镜检查结合光相十断层扫描(OCT)确诊为黄斑区浆液性神经上皮脱离患者46例49只眼的临床资料进行同顾性分析.所有患者均接受荧光素眼底血管造影(FFA)、吲哚青绿血管造影(ICGA)检查.结合 FFA、ICGA和OCT检查做出诊断.结果 中心性浆液性脉络膜视网膜病变(CSC)31例34只眼,占所有患者的69.4%.其中,9例12只眼呈典型CSC表现,占CSC患者的35.3%;22例22只眼为慢性CSC,占CSC患者的64.7%.渗出型老年性黄斑变性(AMD)12例12只眼,占所有患者的24.5%.其中隐匿型9例,占AMD患者的75%;轻微经典型2例,占16.7%;经典型1例,占8.3%.息肉样脉络膜血管病变(PCV)3例3只眼,占6.1%.结论 45岁以上患者发生单纯黄斑区浆液性神经上皮脱离病因复杂,ICGA检查对慢性CSC、隐匿型CNV和PCV鉴别诊断有一定的作用.     

黄斑水肿的光相干断层扫描分析

目的 观察黄斑水肿的光相干断层扫描（OCT）图像特征；探讨黄斑中心凹厚度与最佳矫正视力之间的关系。 方法 对50例正常对照者以及47例54只经直接、间接检眼镜、三面镜及荧光素眼底血管造影（FFA）诊断为黄斑水肿的患眼进行OCT检查，通过黄斑中心凹的水平或垂直方向线性扫描，测量黄斑中心凹的厚度，对比分析两组受检者的黄斑形态及中心凹厚度值，根据形态学特点对黄斑水肿者的OCT图像进行分类并将其中心凹厚度与其最佳矫正视力进行相关分析。 结果 正常对照组与黄斑水肿组黄斑形态及中心凹厚度差异有显著性的意义。黄斑水肿患眼的OCT图像表现为3种特征，20只眼表现为黄斑区视网膜海绵样肿胀，占37.1%；26只眼表现为黄斑囊样水肿，占48.1%；8只眼表现为浆液性视网膜神经上皮脱离，占14.8%。黄斑水肿者黄斑中心凹厚度与其最佳矫正视力呈负相关（r=－0.569, P=0.000）。 结论 黄斑水肿的OCT图像主要包括视网膜海绵样肿胀、黄斑囊样水肿及神经上皮浆液性脱离。黄斑水肿患者的黄斑中心凹厚度明显增厚，黄斑中心凹厚度越厚，视力越差。 （中华眼底病杂志，2004，20：152-155）     

Resolution of diabetic cystoid macular edema associated with spontaneous vitreofoveal separation

PURPOSE: To report spontaneous resolution of diabetic cystoid macular edema (CME) associated with spontaneous vitreofoveal separation. DESIGN: Interventional case series. METHODS: Optical coherence tomography (OCT) was performed on three eyes of three diabetic patients with CME before and after vitreofoveal separation. RESULTS: In all three eyes, OCT showed cystic changes at the fovea with a slightly detached posterior hyaloid, which remained attached to the optic disk and the fovea. After spontaneous separation of the hyaloid at the fovea, there was resolution of the cystic cavities and restoration of the foveal depression. CONCLUSIONS: In some eyes of diabetic patients, CME is caused by a vitreous traction. Resolution of CME may occur after spontaneous vitreofoveal separation.     

Comparison between optical coherence tomography and fundus fluorescein angiography for the detection of cystoid macular edema in patients with uveitis

PURPOSE: To compare optical coherence tomography (OCT) with fundus fluorescein angiography (FFA) for the detection of cystoid macular edema (CME) in patients with uveitis. DESIGN: Prospective comparative observational series. PARTICIPANTS: One hundred twenty-one eyes of 58 patients with uveitis of varied causes (seven patients were studied twice). TESTING: Patients with suspected CME underwent OCT scanning followed by FFA at the same visit. MAIN OUTCOME MEASURES: Detection and distribution of macular edema. RESULTS: One hundred eight eyes had similar results on both OCT and FFA in that 67 eyes had CME and 41 eyes had no CME. In 10 eyes subretinal fluid was detected on OCT but not FFA. Five of these eyes had CME on FFA but not OCT. Three other eyes had CME that was detected by FFA but not by OCT. Compared with FFA, the OCT sensitivity for detecting CME was 96% (including the eyes with subretinal fluid), and the OCT specificity was 100%. CONCLUSIONS: OCT is as effective at detecting CME as is FFA but is superior in demonstrating axial distribution of fluid.     

Optical coherence tomography in the assessment of retinal pigment epithelial tear

PURPOSE: To study the findings of optical coherence tomography (OCT) in retinal pigment epithelial (RPE) tears. METHODS: Sixteen eyes of 16 consecutive patients with age-related macular degeneration complicated by RPE tear were studied using OCT. Fluorescein angiography also was performed. Thirteen eyes were at the acute stage and three eyes were at the scarring stage, still with a recognizable tear. RESULTS: Optical coherence tomography identified an RPE detachment (PED) with focal interruption of the RPE in all cases. Optical coherence tomography always highlighted a peculiar non-dome-shaped profile of the serous PED, as opposed to that of the PED not complicated by an RPE tear. A very intense hyperreflectivity was observed in the OCT scans performed through the retracted RPE. A deep hyperreflectivity under the line corresponding to the RPE was evident in the area of the bare choroid. No choroidal neovascularization could be visualized using OCT, either at the acute or at the scarring stages. CONCLUSIONS: Optical coherence tomography, a noncontact, noninvasive imaging technique, may be a useful tool, complementary to fluorescein angiography, in the clinical assessment of RPE tears.     

糖尿病性黄斑水肿OCT和FFA形态学分类的对比分析

目的探讨糖尿病性黄斑水肿相干光断层扫描(OCT)和眼底荧光素血管造影(FFA)的形态学特征、分类及相互关系。设计前瞻性病例系列。研究对象临床有意义糖尿病性黄斑水肿(CSME)患者102例177眼。方法分别对CSME组患者进行OCT及FFA检查,观察两种分类之间的相互关系,并与中心凹中心厚度、最佳矫正视力等临床资料进行对比分析。主要指标CSME患者的OCT及FFA类型、中心凹中心厚度、最佳矫正视力。结果FFA分类的局限水肿型在OCT1型中所占的比例为70.6%,高于弥漫水肿型(27.2%)和囊样水肿型(2.2%)(P<0.05)。FFA弥漫水肿型在OCT2型中占47.9%,明显高于局限水肿型(25.0%)和囊样水肿型(27.1%)(P<0.05)。FFA分类的囊样水肿型在OCT3型(3A型 3B型)中占56.8%,明显高于局限水肿型(10.8%)和弥漫水肿型(32.4%)(P<0.05)。OCT1型及FFA局限水肿型的矫正视力最好,黄斑中心凹中心厚度值最小(P<0.05)。结论CSME患者OCT与FFA的形态学类型密切相关。结合两种检查方法,可更加全面地反映CSME患者黄斑区视网膜的变化,为揭示糖尿病性黄斑水肿的病理机制、寻求每种类型的最佳治疗方案提供参考。     

Regression of serous macular detachment after intravitreal triamcinolone acetonide in patients with diabetic macular edema

PURPOSE: To evaluate the effect of intravitreal triamcinolone acetonide on serous macular detachment in eyes with diabetic macular edema. DESIGN: Interventional case series. METHODS: The study population comprised twenty eyes of 20 patients with diabetic macular edema (12 men, eight women), aged 48 to 76 years. The eligibility criteria for this study included clinically detectable macular edema in which the presence of serous macular detachment was documented by optical coherence tomography. After intravitreal injection of 0.1 ml (4 mg) triamcinolone acetonide, visual and anatomic responses were observed. RESULTS: In all eyes, after an injection of triamcinolone acetonide, macular edema and serous macular detachment regressed. At 3 and 6 months, macular edema and serous macular detachment had recurred in eight (40%) and nine eyes (45%), respectively. Patients with recurrence were re-treated. No eyes lost vision at 1 month, and all eyes showed improvement. At 3 months, no eyes had lost vision from baseline, and 17 eyes (85%) showed improvement. At 6 months, again no eyes had lost vision from baseline, and 16 eyes (80%) maintained improved visual acuity. CONCLUSION: Intravitreal triamcinolone acetonide is an effective treatment for serous macular detachment in patients with diabetic macular edema.     

Comparison of serum glycosylated hemoglobin levels in patients with diabetic cystoid macular edema with and without serous macular detachment

Aim:

A clinical comparative trial was conducted to compare the levels of glycosylated hemoglobin (HbA1c) in patients with diabetic cystoid macular edema (CME) with and without serous macula detachment (SMD).

Materials and Methods:

Thirty patients (group 1) with diabetic CME in both eyes, but without SMD, and 30 patients (group 2) with diabetic CME and SMD in both eyes documented by optical coherence tomography (OCT) and fundus fluorescein angiography (FFA), were included in the study. In addition to the measurement of central macular thickness by OCT and visual acuity (VA) (as logMAR) using the the early treatment diabetic retinopathy study (ETDRS) chart, the concentrations of HbA1c were measured by high performance liquid chromatography (HPLC). Statistical analysis was done by independent samples t test.

Results:

The mean logMAR VA was 0.8 ± 0.22 (1.0–0.5) in group 1and 0.7 ± 0.16 (1.0–0.6) in group 2. The mean central macular thickness, as determined by OCT, was 468.70 ± 70.44 μm (344–602 μm) in group 1 and 477.80 ± 73.34 μm (354–612 μm) in group 2. The difference between the groups was not statistically significant (P = 0.626). The mean HbA1c levels were 8.16 ± 0.99% in group 1 and 10.05 ± 1.66% in group 2. The difference between the groups was statistically significant (P < 0.001).

Conclusions:

The presence of SMD and high HbA1c levels in the patients with diabetic CME may be indirectly suggestive of retinal pigment epithelium dysfunction.