scholarly journals Correlating the patterns of Diabetic macular edema, Optical Coherence Tomography Biomarkers and Grade of Diabetic Retinopathy With Stage of Renal Disease

2021 ◽  
Author(s):  
Manisha Agarwal ◽  
Mani Sachdeva ◽  
Shalin Shah ◽  
Rajiv Raman ◽  
Padmaja Kumari Rani ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Cross Sectional Study ◽  
Optical Coherence ◽  
Morphological Pattern ◽  
Cross Sectional ◽  
Ckd Stage ◽  
Morphological Patterns

Abstract PurposeTo correlate Optical coherence tomography (OCT) based morphological patterns of diabetic macular edema (DME), prognostic biomarkers and grade of diabetic retinopathy (DR) in patients with various stages of chronic kidney disease (CKD) secondary to diabetes. DesignMulticentric retrospective cross-sectional study conducted at seven centres across India.MethodsData from medical records of patients with DME and CKD was entered in a common excel sheet across all seven centers. Staging of CKD was based on estimated glomerular filtration rate (eGFR). ResultsThe most common morphological pattern of DME was cystoid pattern (42%) followed by the mixed pattern (31%). The proportion of different morphological patterns did not significantly vary across various CKD stages (p=0.836). Presence of external limiting membrane-ellipsoid zone (ELM-EZ) defects (p<0.001) and foveal sub-field thickness (p=0.024) showed a direct correlation with the stage of CKD which was statistically significant. Presence of hyper reflective dots (HRD) and disorganization of inner retinal layers (DRIL) showed no significant correlation with the stage of CKD. Sight threatening DR was found to increase from 70% in CKD stage-3 to 82% in stage-4 and 5 of CKD and this was statistically significant (p=0.03).ConclusionsCystoid morphological pattern followed by mixed type was the most common pattern of DME on OCT found in patients suffering from stage 3 to 5 of CKD. However, the morphological patterns of DME did not significantly vary across various CKD stages. ELM-EZ defects may be considered as an important OCT biomarker for advanced stage of CKD.

scholarly journals Optical coherence tomography in diabetic macular edema: patterns and related risk factors

2013 ◽  
Vol 5 (2) ◽  
pp. 190-194 ◽  
Author(s):  
Mohammadreza Ahmadpour-Baghdadabad ◽  
Masoudreza Manaviat ◽  
Ahmad Shojaoddiny-Ardekani
Keyword(s):  
Risk Factors ◽  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Cross Sectional Study ◽  
Optical Coherence ◽  
Foveal Thickness ◽  
Cross Sectional

Introduction: Diabetic Macular Edema (DME) is an important cause of vision loss in diabetic retinopathy. Optical Coherence Tomography (OCT) is a non-invasive modality that produces high-resolution images of retinal layers. Objective: To evaluate the prevalence of DME patterns and their association with risk factors and visual acuity. Materials and Methods: In this cross-sectional study, type 2 diabetics with macular edema referred to our center during a ten-month period underwent OCT. Patients with macular edema due to causes other than diabetes and with OCT images of improper quality were excluded from the study. Four distinct patterns were found in the OCT images. A questionnaire including age, sex, duration of diabetes, serum TG and cholesterol, HbA1c, BMI and visual acuity, as well as the findings of OCT images were filled for the subjects. Results: Eighty-six eyes from 46 patients were evaluated. The most and the least common patterns were sponge-like retinal swelling (SLRS) and posterior hyaloidal traction (PHT) found in 64.0% and 5.8% of the subjects, respectively. A sub-retinal fluid pattern was more common in males (p=0.011) and in patients with serum TG > 200mg/dl (p=0.037). There were significant associations between central foveal (r=0.45, p<0.001), nasal (r=0.35, p=0.001) and temporal (r=0.32, p=0.003) thicknesses with visual acuity. Moreover, the highest thickness (462.4±119.2μm) and also the worst visual acuity (1.0±0.5logMAR) pertained to the cystoid macular edema (CME) pattern. Conclusion: Our study showed that the most common OCT pattern of DME is the sponge-like retinal swelling, while posterior hyaloidal traction has the lowest prevalence. A higher foveal thickness and a lower visual acuity are seen in the CME pattern. Nepal J Ophthalmol 2013; 5(10): 190-194 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8727

scholarly journals Fundus Fluorescein Angiography and Optical Coherence Tomography Angiography Findings in Diabetic Retinopathy and Diabetic Macular Edema

2018 ◽  
pp. 130-137
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Fluorescein Angiography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Optical Coherence Tomography Angiography ◽  
Imaging Technique ◽  
Diabetic Patients ◽  
Type I ◽  
Optical Coherence

Diabetic retinopathy is an important public health issue as its prevalence has been increasing every year. It is one of the major causes of visual loss which can be preventable with early diagnosis and appropriate treatment. The fundus examination must be done in detail using mydriatics, and digital images must be recorded in all diabetic patients with special emphasis on the disease type (type I and type II), duration, and prognosis. Fluorescein angiography (FA) is a gold standard invasive retinal imaging technique for the diagnosis, monitoring, and evaluating the response of the treatment in diabetic patients, but FA has limitations due to possible side effects. Optical coherence tomography angiography (OCTA) is a recent, non-invasive, dye-free imaging technique that can be used in every visit. It has the capability to image all retinal and choroidal vascular layers (segmentation) and quantify macular ischemia in a short period of time which is beneficial for the patient, and the ophthalmologist. The aim of this review is to address the findings, advantages, and disadvantages of FA and OCTA in patients with diabetic retinopathy and diabetic macular edema.

scholarly journals Vascular density of optic nerve head in diabetic retinopathy using optical coherence tomography angiography

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Fariba Ghassemi ◽  
Sahar Berijani ◽  
Ramak Roohipoor ◽  
Masoumeh Mohebbi ◽  
Ameneh Babeli ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Optical Coherence Tomography Angiography ◽  
Blood Perfusion ◽  
Cross Sectional Study ◽  
Vascular Density ◽  
Optical Coherence ◽  
Cross Sectional

Abstract Purpose To measure optic nerve head (ONH) blood perfusion using optical coherence tomography angiography (OCTA) at various stages of diabetic retinopathy (DR). Methods One hundred seventy six eyes of 94 patients included in this retrospective single-centre cross-sectional study. The subjects were studied in normal, no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative retinopathy (PDR) groups. The eyes were subjected to AngioDisc ONH imaging using OCTA for papillary (Disc) and peripapillary (RPC) vascular density (VD) evaluation. Results The mean age of the participants was 56.08 ± 8.87 years and 34 (36.2 percent) were male. With increased DR severity, a statistically significant decrease in peripapillary VD was found. The study showed that only VD of the whole RPC (W-RPC) could be a valid biomarker in the staging assessment. VD of RPC, in all subsections, was considerably different from normal cases in the PDR group. Visual acuity was correlated with whole image ONH VD. The duration of DM, FBS, hyperlipidemia and DME had no effect on the ONH perfusion. Conclusions The study showed that only the W-RPC VD could be a reasonable marker in the staging assessment. VDs assessed by OCTA can be useful for assessing and tracking early ONH changes in DR patients.

Influence of the thickness and vascular density of the retina on its photosensitivity in diabetic macular edema

2021 ◽  
pp. 37-40
Author(s):  
D.D. Arzhukhanov ◽  
◽  
D.V. Petrachkov ◽  
A.G. Matyushchenko ◽  
◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Central Zone ◽  
Vascular Density ◽  
Ophthalmological Examination ◽  
Optical Coherence ◽  
Correlation Relationship ◽  
Functional Changes

Purpose: to study the effect of the thickness and vascular density of the retina on its photosensitivity in diabetic macular edema. Material and methods. 9 patients (13 eyes) aged from 26 to 79 years (average age 62.1 ± 16 years) with a diagnosis of diabetic retinopathy (DR), diabetic macular edema (DME) were examined. In addition to the standard ophthalmological examination, a complex of specialized research methods was performed, including microperimetry, optical coherence tomography (OCT) and OCT with angiography (OCT-angio) of the posterior segment of the eye. At the same time, the influence of morphometric parameters on functional changes in the retina in the corresponding segments with a diameter of 6 mm was analyzed. Results. The study was a high inverse correlation relationship in the majority of cases between the parameters of the relevant sectors according microperimetry and OCT and OCT-angio in central zone of diameter 1, 3 and 6 mm and a direct correlation between central retinal thickness by OCT diagnosis and the so-called parameter K, denoting the number of points with sensitivity below 24 dB according microperimetry with a high degree of confidence (p<0.01, p<0.05). Conclusion. According to the results of our study, a direct correlation was found between the vascular density of the superficial and deep capillary plexuses and the parameters of photosensitivity in patients with DME. At the same time, the relationship between the thickness and light sensitivity of the retina is inverse. Key words: diabetic retinopathy, diabetic macular edema, optical coherence tomography, microperimetry, angiography.

scholarly journals Large-cube 30° × 25° optical coherence tomography in diabetic macular edema

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Amir Mahdjoubi ◽  
Youcef Bousnina ◽  
Fatma-Samia Bendib ◽  
Faiza Bensmaine ◽  
Wafa Idlefqih ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Strong Association ◽  
Intravitreal Injections ◽  
Binary Logistic Regression Analysis ◽  
Optical Coherence ◽  
Retinal Edema ◽  
Baseline Visit

Abstract Background To evaluate the contribution of large-cube 30° × 25° optical coherence tomography (OCT) in the characterization of diabetic macular edema (DME) by assessing its extent and the presence of additional retinal edemas and to evaluate the factors that influenced their occurrence. Methods This retrospective study enrolled patients with diabetes who presented with retinal edema detected by horizontal large-cube 30° × 25° (8.7 × 7.3 mm) OCT. Two individualized areas were selected from the thickness map: the area within the 6-mm Early Treatment of Diabetic Retinopathy Study (ETDRS) grid, and that outside the ETDRS grid. Retinal edemas located within the ETDRS grid were designated as “main DME” and those located outside the ETDRS grid were designated as “peripheral retinal edemas.” For each area, OCT features were assessed while the extent of the main DME and the presence of peripheral retinal oedema were analysed in the area outside the ETDRS grid. Finally, part of included eyes was followed by the same protocol, of which a part benefited from intravitreal injections. Results Peripheral events were detected outside the ETDRS area in 279 eyes (74.4%) of the 375 eyes of the 218 patients included in this study: an extension of the main DME outside ETDRS grid in 177 eyes (47.2%) and/or the presence of peripheral retinal edemas in 207 eyes (55.2%). The analysis of associations between main DME and peripheral retinal edemas patterns did not find an association for retinal cyst localization (P = 0.42) while a week association was found fort cyst size (Cramer’s V = 0.188, p = 0.028). Nevertheless, a moderate association was found for the presence of microaneurysms (Cramer’s V = 0.247, p < 0.001) and strong association for hard exudates (Cramer’s V = 0.386, p < 0.001), The binary logistic regression analysis retained the following influencing factors of the occurrence of peripheral events: advanced DR stage (Odds ratio OR = 2.19, p = 0.03), diffuse DME (OR = 7.76, p < 0.001) and its location in outer fields (OR = 7.09, p = 0.006). Likewise, the extension of the main DME outside the ETDRS area in was influenced by the same factors in addition to CMT (OR = 0.98, p = 0.004) while the presence of peripheral retinal edema was influenced by the same factors except the outer location of the Main DME. Finally, from the 94 eyes treated by intravitreal injections, extension of the main DME outside the ETDRS grid was detected in 54 eyes (56.44%) at baseline visit and still remained detectable in 37 eyes (39.36%) after treatment initiation. Conclusions Large-cube 30° × 25° OCT allowed for more precise assessment of DME extension and better detection of retinal thickening mainly in the advanced stages of diabetic retinopathy with significant DME whether at the baseline visit or during follow-up. The combination of this protocol with a wider ETDRS grid would enhance DME detection and topography.

scholarly journals Detection of Diabetic Macular Edema in Optical Coherence Tomography Image Using an Improved Level Set Algorithm

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Zhenhua Wang ◽  
Wenping Zhang ◽  
Yanan Sun ◽  
Mudi Yao ◽  
Biao Yan
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Level Set ◽  
Diabetic Patients ◽  
Optical Coherence Tomography Image ◽  
Optical Coherence ◽  
Oct Image ◽  
Novel Algorithm

Diabetic macular edema (DME) is a major cause of visual loss in the patients with diabetic retinopathy. DME detection in Optical Coherence Tomography (OCT) image contributes to the early diagnosis of diabetic retinopathy and blindness prevention. Currently, DME detection in the OCT image mainly relies on the handwork by the experienced clinician. It is a laborious, time-consuming, and challenging work to organize a comprehensive DME screening for diabetic patients. In this study, we proposed a novel algorithm for the detection and segmentation of DME region in OCT image based on the K-means clustering algorithm and improved Selective Binary and Gaussian Filtering regularized level set (SBGFRLS) algorithm named as SBGFRLS-OCT algorithm. SBGFRLS-OCT algorithm was compared with the current level set algorithms, including C-V (Chan-Vese), GAC (geodesic active contour), and SBGFRLS, to estimate the performance of DME detection. SBGFRLS-OCT algorithm was also compared with the clinician to estimate the precision, sensitivity, and specificity of DME segmentation. Compared with C-V, GAC, and SBGFRLS algorithm, the SBGFRLS-OCT algorithm enhanced the accuracy and reduces the processing time of DME detection. Compared with manual DME segmentation, the SBGFRLS-OCT algorithm achieved a comparable precision (97.7%), sensitivity (91.8%), and specificity (99.2%). Collectively, this study presents a novel algorithm for DME detection in the OCT image, which can be used for mass diabetic retinopathy screening.

scholarly journals Association of periodontitis and diabetic macular edema in various stages of diabetic retinopathy

2021 ◽  
Author(s):  
Marlene Lindner ◽  
Behrouz Arefnia ◽  
Domagoj Ivastinovic ◽  
Harald Sourij ◽  
Ewald Lindner ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Pocket Depth ◽  
Cross Sectional ◽  
Early Stages ◽  
Surface Areas ◽  
Late Stages

Abstract Objectives Periodontitis and diabetes are known to have a bidirectional relationship. Diabetic macular edema is a complication of diabetes that is strongly influenced by inflammatory pathways. However, it remains to be established whether inflammation at other locations, such as periodontitis, affects diabetic macular edema. Here, we investigated the prevalence of periodontitis in patients treated for diabetic macular edema. Materials and methods Patients with diabetic macular edema were recruited for this cross-sectional study at the Medical University of Graz. Macular edema was documented by optical coherence tomography. Periodontal status was assessed by computerized periodontal probing and panoramic X-ray imaging. Bleeding on probing, clinical attachment level, probing pocket depth, and plaque index were compared between different stages of diabetic retinopathy. Results Eighty-three eyes of 45 patients with diabetic macular edema were enrolled. Forty-four eyes (53.0%) had early stages of diabetic retinopathy (mild and moderate), and 39 eyes (47.0%) had late stages (severe and proliferative). Patients with mild or moderate DR were more likely to have more severe periodontal conditions than patients with severe or proliferative DR. Fourteen patients with mild DR (82.4%), 7 patients with moderate DR (87.5%), 4 patients with severe DR (100.0%), and 15 patients with proliferative DR (93.8%) had some degree of PD. The periodontal inflamed surface areas and the percentages of tooth sites that bled on probing were significantly higher in patients with early stages of diabetic retinopathy than in those with late stages of the disease (p < 0.05). Patients with periodontal inflamed surface areas of more than 500 mm2 required significantly more intravitreal injections in the last year than those with milder forms of periodontitis (n = 6.9 ± 3.1 versus n = 5.0 ± 3.5, p = 0.03). Conclusion In patients with diabetic macular edema, periodontitis is more prevalent in early stages of diabetic retinopathy. We suggest regular dental check-ups for diabetic patients, especially when diabetic macular edema is already present. Clinical relevance Patients with diabetic macular edema should be screened for periodontitis and vice versa, particularly early in the course of diabetes.

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