Title: Central Macular Thickness analysis in Diabetic Retinopathy

Authors: Ravinder K. Gupta, Abhishek Padha, Swati Sharma

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.39

Abstract

Background: Diabetic Maculopathy is a common complication of diabetes mellitus, characterized by macularedema and frequently accompanied by lipid exudation. It is the major cause of loss of vision from diabetic retinopathy.

Purpose: To assess the changes in central macular thickness in diabetics with different stages of retinopathy and in non-diabetic controls.

Materials and Methods: This retrospective observational study was conducted in the

Department of Ophthalmology in Maharishi Markandeshwar Medical College & Hospital, Solan, H.P, India. It was conducted on 100 eyes of 50 diabetics and non-diabetics each and  the data records of 50 random patients of diabetic retinopathy, on whom FFA for studying the severity of diabetic retinopathy as well as OCT (Cirrus HD-OCT 500) for macular thickness was performed .Comparison of  central macular thickness with increasing severity of diabetic retinopathy was done.

Results: The mean age of patients and the mean central macular thickness in the study population was found to be 55.7±9.05 years and 297.12±95.8 µm. Whereas in the control group the mean central macular thicknes was calculated to be 211.06±7.6 µm. Central macular Thickness was found to be directly proportional to increasing stage of Diabetic Retinopathy.

Conclusion: OCT is a very sensitive tool for detection of macular oedema even in the stages when there is no suspicion of clinically significant macular oedema. It can be used in the regular follow up and monitoring of patients with diabetic retinopathy.

Keywords: Central Macular Thickness, Diabetic Macular oedema, OCT.

References

  1. Bhavsar AR, Drouilhet JH, Atebara NH, et al: Diabetic Retinopathy. 2014, http:// emedicine.medscape.com/ article/1225122-overview#a0156
  2. Klein R, Klein BE, Moss SE, et al. The Wisconsin epidemiologic study of diabetic retinopathy: XVII. The 14- year incidence and progression of diabetic retinopathy and associated risk factors in type 1 diabetes. Ophthalmology 1998;105(10): 1801-1815.
  3. Congdon N, O'Colmain B, Klaver CC, et al. Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol 2004;122(4):477-485.
  4. Wild S, Roglic G, Green A, et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27(5):1047-1053.
  5. Biallosterski C, van Velthoven ME, Michelis RP, et al. Decreased optical coherence tomography-measured pericentral retinal thickness in patients with diabetes mellitus type 1 with minimal diabetic retinopathy. Br J Ophthalmol 2007;91(9): 1135-1138.
  6. Browning DJ, McOwen MD, Bowen Jr RM, O’Marah TL. Comparison of the clinical diagnosis of diabetic macular edema with diagnosis by optical coherence tomography. Ophthalmology 2004; 111(4): 712–715.
  7. Supplement 1. American diabetes association: clinical practice recommend-dations 2000. Diabetes Care 2000;23(Suppl 1):S1-116.
  8. Yang CS, Cheng CY, Lee FL, et al. Quantitative assessment of retinal thickness in diabetic patients with and without clinically significant macular edema using optical coherence tomog-raphy. Acta Ophthalmol 2001;79(3):266-270.
  9. Schaudig UH, Glaefke C, Scholz F, et al. Optical coherence tomography for retinal thickness measurement in diabetic patients without clinically significant macular edema. Ophthalmic Surg Lasers 2000;31(3):182-186.
  10. Brown JC, Solomon SD, Bressler SB, et al. Detection of diabetic foveal edema: contact lens biomicroscopy compared with optical coherence tomography. Arch Ophthalmol 2004;122(3):330-335.
  11. Sanchez-Tocino H, Alvarez-Vidal A, Maldonado MJ, et al. Retinal thickness study with optical coherence tomography in patients with diabetes. Invest Ophthal Vis Sci 2002;43(5):1588-1594.
  12. Kanski JJ, Bowling B, Nischal KK, et al. Retinal vascular disease. In: Clinical ophthalmology: a systematic approach.7th edn. London: Elsevier Saunders 2011:534-543.
  13. Massin P, Erginay A, Haouchine B, et al. Retinal thickness in healthy and diabetic subjects measured using optical coherence tomography mapping software. Eur J Ophthalmol 2002;12(2):102-108.
  14. Sander B, Larsen M, Engler C, et al. Early changes in diabetic retinopathy: capillary loss and blood-retina barrier permeability in relation to metabolic control. Acta Ophthalmol 1994;72(5):553-559.
  15. Oshitari T, Hanawa K, Adachi-Usami E. Changes of macularand RNFL thickness measured by straus OCT in patients with early stage diabetes. Eye 2009;23(4):884-889.
  16. Nussenblatt RB, Kauffman SC, Palestine AG, et al. Macular thickening and visual acuity. Measurement in patients with cystoid macular edema. Ophthalmology 1987;94(9):1134- 1139.
  17. Massin P, Erginay A, Haouchine B, et al. Retinal thickness in healthy and diabetic subjects measured using optical coherence tomography mapping software. Eur J Ophthalmol 2002;12(2):102-108

Corresponding Author

Dr Abhishek Padha

Address: Near National Highway, Diani, Samba -184121, J&K India

Mob: 9796718740, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.