Correlation between visual acuity and foveal microstructural changes in diabetic macular edema

Area of Science:

• Ophthalmology
• Retinal Imaging
• Diabetic Retinopathy

Background:

• Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
• Assessing visual acuity and foveal microstructure is crucial for understanding DME progression and treatment outcomes.

Purpose of the Study:

• To investigate the correlation between best-corrected visual acuity (BCVA) and foveal microstructural integrity in DME.
• To compare the predictive value of external limiting membrane (ELM) and photoreceptor inner/outer segment junction (IS/OS) integrity versus central subfield thickness (CST) on BCVA.

Main Methods:

• Spectral-domain optical coherence tomography (SD-OCT) was used to image the macula in eyes with DME.
• Measurements included the length of disruption in the ELM and IS/OS junction within a 1.8 mm foveal diameter.
• ELM and IS/OS disruption were graded based on length, and CST was defined as the average retinal thickness in the central 1 mm.

Main Results:

• BCVA showed strong positive correlations with ELM integrity scores (r = 0.66) and IS/OS junction integrity scores (r = 0.68).
• BCVA had a weak negative correlation with CST (r = -0.23).

Conclusions:

• SD-OCT reveals that the integrity of the ELM and IS/OS junction is a more significant correlate of BCVA in DME than CST.
• Preserving foveal microstructural integrity is critical for maintaining visual function in patients with diabetic macular edema.