En face image-based classification of diabetic macular edema using swept source optical coherence tomography

Area of Science:

• Ophthalmology
• Retinal Imaging
• Diabetic Retinopathy

Background:

• Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
• Accurate classification of DME is essential for predicting visual outcomes.
• Current classification methods may not fully capture the impact of fluid localization.

Purpose of the Study:

• To classify diabetic macular edema (DME) based on fluid localization and area using en face optical coherence tomography (OCT).
• To investigate the relationship between DME fluid classification and visual acuity (VA).

Main Methods:

• Retrospective study of 128 eyes with DME.
• Fluid visualization using en face swept-source OCT.
• Retinal segmentation into two segments based on layer composition.
• Classification of DME based on fluid presence and location within segments.

Main Results:

• Five DME classifications were identified based on fluid distribution.
• Eyes with fluid in Segment 2 (outer nuclear layer) showed significantly poorer VA.
• Fluid in Segment 2 correlated with higher ellipsoid zone disruption and increased central subfield thickness.

Conclusions:

• Fluid localization and area are critical factors in determining visual acuity in DME.
• The presence of fluid in deeper retinal layers (Segment 2) is a significant predictor of poor visual outcomes.
• This classification system provides valuable insights for managing DME and predicting patient prognosis.