Association between Visual Acuity and Retinal Layer Metrics in Diabetics with and without Macular Edema

Area of Science:

• Ophthalmology
• Medical Imaging
• Diabetology

Background:

• Diabetes mellitus can cause microvascular and tissue changes in the retina, leading to progressive visual impairment.
• Diabetic macular edema (DME) is a common complication characterized by retinal thickening.
• Optical coherence tomography (OCT) is a key imaging modality for assessing retinal changes in DME.

Purpose of the Study:

• To investigate the relationship between visual acuity (VA) and enface OCT-derived metrics of retinal layer thickness, reflectance, and interface disruption.
• To analyze these associations in both diabetic subjects with and without DME.

Main Methods:

• High-density OCT volume scans were acquired from 149 diabetic subjects.
• Enface thickness and reflectance maps of individual retinal layers were generated.
• Multivariate linear regression analysis was used to determine associations between VA and retinal metrics, adjusting for covariates.

Main Results:

• In DME patients, reduced VA correlated with increased inner retinal layer thickness (GCLIPL, OPL), decreased photoreceptor outer segment layer (OSL) thickness, altered NFL and OSL reflectance, and increased INL/ONL interface disruptions.
• In non-DME subjects, increased INL thickness was linked to reduced VA.
• In previously treated non-DME subjects, OPL thickening was associated with reduced VA.

Conclusions:

• Enface OCT-derived retinal layer thickness, reflectance, and interface disruption metrics are associated with visual acuity in diabetic individuals, both with and without DME.
• These OCT findings suggest potential for monitoring DME development, progression, and treatment response.