STRUCTURAL CHANGES IN INDIVIDUAL RETINAL LAYERS IN DIABETIC MACULAR EDEMA: AN OBSERVATIONAL STUDY
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Keywords
Diabetic macular edema, optical coherence tomography, retinal layers, central macular thickness, ellipsoid zone, OCT
Abstract
Background: IBackground: Diabetic macular edema (DME) is a major cause of visual impairment in patients with diabetic retinopathy. Optical coherence tomography (OCT) provides high-resolution cross-sectional imaging of the retina and allows quantitative assessment of individual retinal layers. Structural alterations in specific retinal layers may be associated with visual dysfunction and the severity of macular edema.
Aim: To study the structural changes in individual retinal layers in patients with diabetic macular edema using spectral-domain optical coherence tomography.
Materials and Methods: A hospital-based observational study was conducted among 40 patients with diabetic macular edema attending the Department of Ophthalmology. Patients underwent comprehensive ophthalmic examination including best-corrected visual acuity, slit-lamp examination, fundus examination and spectral-domain OCT of the macula. Central macular thickness and thickness/structural abnormalities of individual retinal layers were evaluated. OCT findings including intraretinal cystoid spaces, disorganization of retinal inner layers, disruption of the ellipsoid zone and external limiting membrane, and changes in the outer retinal layers were documented.
Results: Among the 40 patients studied, OCT demonstrated variable involvement of individual retinal layers. The most commonly observed structural abnormalities included increased central macular thickness, intraretinal cystoid spaces and alterations of the inner retinal layers. Disruption of the ellipsoid zone and other outer retinal structures was observed in patients with more pronounced macular involvement. Visual acuity showed a tendency to be poorer in patients with greater structural disruption.
Conclusion: Diabetic macular edema is associated with structural alterations involving multiple retinal layers. OCT provides useful quantitative and qualitative information regarding these changes and may help in assessing the severity and functional consequences of DME.
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