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[Quantification of cystoid changes in diabetic macular edema]
1Universitäts-Augenklinik, Medizinischen Fakultät, Rheinisch-Westfälischen Technischen Hochschule Aachen.
Background:
Cystoid changes in diabetic macular oedema can result in severe visual consequences and were previously difficult to quantify. This study was performed to introduce reliable measurements of the area covered by cysts, of their quantification and relation to visual acuity.
Patients And Methods:
58 diabetic patients suffering from cystoid macular oedema were examined by means of a scanning laser ophthalmoscope. Fluorescein angiography provides a detailed recognition of well demarcated cystoid formations in the early transit. In three different sampling areas from the center of the fovea (1.2 deg, 2.5 deg and 5 deg) and in the foveal avascular zone (FAZ) itself the area covered by cystoid changes was quantified as well as the number of cysts and their shortest distance from the center of the FAZ.
Results:
The mean area covered by cystoid formations in the 2.5 degrees area was 0.128 +/- 0.08 micron2, the number of cysts ranged from 1 to 7. In all sampling areas there was a significant correlation between area of cysts and visual acuity. Their number and distance from the center of the FAZ did not show a significant correlation to vision. Measurements within the 2.5 degrees area seem to have the highest predictability concerning visual function.
Conclusion:
Fluorescein angiography allows the quantification of number and area covered by cystoid formations in patients with diabetic macular oedema. There is a significant correlation of visual acuity to the area covered by these cystoid changes. The distance of cysts from the center of the FAZ does not correlate significantly to visual acuity. These measurements can prove useful in following cystoid changes and in monitoring the effect of currently used therapy regimen.