A cross-sectional study of association between Optical Coherence Tomographic and Fluorescein Angiographic patterns in patients with Diabetic Macular Edema

Purpose: To assess the association between the features of optical coherence tomography (OCT) and fluorescein angiography (FA) in clinically significant diabetic macular edema. Materials and Methods: It was an observational, cross-sectional study conducted at Upgraded Department of Ophthalmology, S.M.S Hospital and Medical College, Jaipur. It involved 181 eyes (100 patients) with clinically significant diabetic macular edema. The FA features were categorized into focal leakage type, diffuse leakage type, and diffuse cystoid leakage type. The OCT features were categorized into five types: Diffuse retinal thickness (DRT), Cystoid macular edema (CME), Serous retinal detachment (SRD), Posterior hyaloidal traction (PHT) and Tractional retinal detachment (TRD). The association between FA types and OCT types were analyzed, and their associations in terms of visual acuity, central foveal thickness and stages of diabetic retinopathy were evaluated. Results: There was a significant correlation (p value < 0.000) between fluorescein angiography types and OCT types. 69% eyes with focal leakage on FA had DRT on OCT while 50 % eyes with diffuse cystoid leakage showed CME on OCT. There was also a significant association of OCT and FA patterns with the stages of diabetic retinopathy and the visual acuity. DRT on OCT and the focal leakage on FA showed the least foveal thickness and the best visual acuity (p value < .000). The foveal thickness increased and visual acuity worsened as the stages of diabetic retinopathy progressed from Mild NPDR to PDR. Conclusions: There was a significant correlation between the features of OCT and fluorescein angiography in clinically significant diabetic macular edema. The analysis of diabetic macular edema based on both OCT and fluorescein angiography can provide information that may be useful to disclose the pathogenesis of the edema and to optimize the treatment for each type.