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Article Type

Original Study

Abstract

Objectives The aim of the study was to evaluate the role of optical coherence tomography (OCT) as a prognostic tool for visual improvement after management of diabetic macular edema (DME). Background OCT provides an easy quantitative assessment of the relationship between DME and visual acuity. Patients and methods Fifty eyes affected with DME were treated and followed up for 6 months. The main outcome measures were best corrected visual acuity (BCVA) and central macular thickness (CMT) in addition to photoreceptor integrity changes, which were measured using OCT at 1 month and 6 months after treatment. Result After treatment of DME, follow-up at 1 month revealed that the mean CMT was significantly higher among patients in the panretinal photocoagulation (PRP) + intravitreal triamcinolone acetonide (IVTA) + grid group compared with the patients in the grid + PRP group (P = 0.001), focal + PRP group (P = 0.01), and focal management group (P = 0.008). The mean BCVA was significantly lower among patients in the grid + IVTA group compared with patients in the grid + PRP group (P = 0.03), focal + PRP group (P = 0.02), and focal treatment group (P = 0.008). After 6 months of treatment, there was no significant difference between the mean values of CMT (P = 0.46) or BCVA (P = 0.07) with respect to different ways of management. With respect to the photoreceptor integrity at 1 month follow-up, the mean CMT was significantly lower in the intact (P = 0.001) and disrupted (P = 0.01) groups compared with that in the absent photoreceptor integrity group, whereas the mean BCVA was significantly higher in the intact group than in the absent (P = 0.001) and disrupted (P = 0.001) photoreceptor integrity groups. At 6 months, the mean CMT of the absent photoreceptor integrity group was significantly higher than that of the intact group (P = 0.03), and the mean BCVA was significantly higher in the intact group than that in the disrupted photoreceptor integrity group (P = 0.01). Conclusion CMT measured using OCT and the status of photoreceptor layer significantly provide an objective guideline for predicting the visual improvement in eyes with DME after treatment.

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