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Diabetic Macular Edema

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Atlas of Swept Source Optical Coherence Tomography

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Abstract

Diabetic macular edema (DME) is one of the most common causes of visual impairment in patients with diabetes mellitus [1]. Physiologically, DME is reported to be induced by disruption of the blood-retinal barrier (BRB) secondary to retinal vessel leukostasis, pericyte loss, and increased permeability of retinal pigment epithelium cells [2]. The disruption of the BRB results in abnormal fluid leakage into the extracellular space and then leads to residual accumulation of fluid into the intraretinal layers [3]. Similarly, various choroidal abnormalities, including obstruction of the choriocapillaris, vascular degeneration, choroidal aneurysms, and choroidal neovascularization, have been reported [4–6]. The introduction of swept source OCT (SS-OCT) made it possible to detect these morphological features of the choroid in patients with DME, such as an irregular-shaped choroidoscleral interface, focal choroidal thinning, and reduction of choriocapillaris layer thickness [7].

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References

  1. Klein R, Lee KE, Knudtson MD, Gangnon RE, Klein BE. Changes in visual impairment prevalence by period of diagnosis of diabetes: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Ophthalmology. 2009;116:1937–42.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Ciulla TA, Amador AG, Zinman B. Diabetic retinopathy and diabetic macular edema: pathophysiology, screening, and novel therapies. Diabetes Care. 2003;26:2653–64.

    Article  PubMed  Google Scholar 

  3. Knudsen ST, Bek T, Poulsen PL, Hove MN, Rehling M, Mogensen CE. Macular edema reflects generalized vascular hyperpermeability in type 2 diabetic patients with retinopathy. Diabetes Care. 2002;25:2328–34.

    Article  PubMed  Google Scholar 

  4. Hidayat AA, Fine BS. Diabetic choroidopathy. Light and electron microscopic observations of seven cases. Ophthalmology. 1985;92:512–22.

    Article  CAS  PubMed  Google Scholar 

  5. Cao J, McLeod S, Merges CA, Lutty GA. Choriocapillaris degeneration and related pathologic changes in human diabetic eyes. Arch Ophthalmol. 1998;116:589–97.

    Article  CAS  PubMed  Google Scholar 

  6. Fukushima I, McLeod DS, Lutty GA. Intrachoroidal microvascular abnormality: a previously unrecognized form of choroidal neovascularization. Am J Ophthalmol. 1997;124:473–87.

    Article  CAS  PubMed  Google Scholar 

  7. Adhi M, Brewer E, Waheed NK, Duker JS. Analysis of morphological features and vascular layers of choroid in diabetic retinopathy using spectral-domain optical coherence tomography. JAMA Ophthalmol. 2013;131:1267–74.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Morigi M, Angioletti S, Imberti B, Donadelli R, Micheletti G, Figliuzzi M, et al. Leukocyte-endothelial interaction is augmented by high glucose concentrations and hyperglycemia in a NF-kB-dependent fashion. J Clin Invest. 1998;101:1905–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005;54:1615–25.

    Article  CAS  PubMed  Google Scholar 

  10. Shams N, Ianchulev T. Role of vascular endothelial growth factor in ocular angiogenesis. Ophthalmol Clin N Am. 2006;19:335–44.

    Google Scholar 

  11. Otani T, Kishi S, Maruyama Y. Patterns of diabetic macular edema with optical coherence tomography. Am J Ophthalmol. 1999;127:688–93.

    Article  CAS  PubMed  Google Scholar 

  12. Kim BY, Smith SD, Kaiser PK. Optical coherence tomographic patterns of diabetic macular edema. Am J Ophthalmol. 2006;142:405–12.

    Article  PubMed  Google Scholar 

  13. Early Treatment Diabetic Retinopathy Study research group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol. 1985;103:1796–806.

    Article  Google Scholar 

  14. Kim JT, Lee DH, Joe SG, Kim JG, Yoon YH. Changes in choroidal thickness in relation to the severity of retinopathy and macular edema in type 2 diabetic patients. Invest Ophthalmol Vis Sci. 2013;54:3378–84.

    Article  PubMed  Google Scholar 

  15. Zhu Y, Zhang T, Wang K, Xu G, Huang X. Changes in choroidal thickness after panretinal photocoagulation in patients with type 2 diabetes. Retina. 2015;35:695–703.

    Article  PubMed  Google Scholar 

  16. Adhi M, Alwassia AA, Duker JS. Analysis of choroidal thickness in eyes treated with focal laser photocoagulation using SD-OCT. Can J Ophthalmol. 2013;48:535–8.

    Article  PubMed  Google Scholar 

  17. Kompella UB, Bandi N, Ayalasomayajula SP. Subconjunctival nano- and microparticles sustain retinal delivery of budesonide, a corticosteroid capable of inhibiting VEGF expression. Invest Ophthalmol Vis Sci. 2003;44:1192–201.

    Article  PubMed  Google Scholar 

  18. Bhisitkul RB, Winn BJ, Lee OT, Wong J, Pereira Dde S, Porco TC, et al. Neuroprotective effect of intravitreal triamcinolone acetonide against photoreceptor apoptosis in a rabbit model of subretinal hemorrhage. Invest Ophthalmol Vis Sci. 2008;49:4071–7.

    Article  PubMed  Google Scholar 

  19. Martidis A, Duker JS, Greenberg PB, Rogers AH, Puliafito CA, Reichel E, et al. Intravitreal triamcinolone for refractory diabetic macular edema. Ophthalmology. 2002;109:920–7.

    Article  PubMed  Google Scholar 

  20. Jonas JB, Kreissig I, Degenring R. Intraocular pressure after intravitreal injection of triamcinolone acetonide. Br J Ophthalmol. 2003;87:24–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Michaelides M, Kaines A, Hamilton RD, Fraser-Bell S, Rajendram R, Quhill F, et al. A prospective randomized trial of intravitreal bevacizumab or laser therapy in the management of diabetic macular edema (BOLT study):12-month data. Report 2. Ophthalmology. 2010;117:1078–86.

    Article  PubMed  Google Scholar 

  22. Massin P. Safety and efficacy of ranibizumab in diabetic macular edema (RESOLVE study): a 12 month, randomized, controlled, double masked, muliticenter phase II study. Diabetes Care. 2010;33:2399–405.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Brown DM, Schmidt-Erfurth U, Do DV, Holz FG, Boyer DS, Midena E, et al. Intravitreal aflibercept for diabetic macular edema: 100-week results from the VISTA and VIVID studies. Ophthalmology. 2015;122:2044–52.

    Article  PubMed  Google Scholar 

  24. Sonoda S, Sakamoto T, Yamashita T, Otsuka H, Shirasawa M, Kakiuchi N, et al. Effect of intravitreal triamcinolone acetonide or bevacizumab on choroidal thickness in eyes with diabetic macular edema. Invest Ophthalmol Vis Sci. 2014;55:3979–85.

    Article  CAS  PubMed  Google Scholar 

  25. Laíns I, Figueira J, Santos AR, Baltar A, Costa M, Nunes S, et al. Choroidal thickness in diabetic retinopathy : the influence of antiangiogenic therapy. Retina. 2014;34:1199–207.

    Article  PubMed  Google Scholar 

  26. Yiu G, Manjunath V, Chiu SJ, Farsiu S, Mahmoud TH. Effect of anti-vascular endothelial growth factor therapy on choroidal thickness in diabetic macular edema. Am J Ophthalmol. 2014;158:745–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Dillnger P, Mester U. Vitrectomy with removal of the internal limiting membrance in chronic diabetic macular oedema. Graefes Arch Clin Exp Opthalmol. 2004;242:630–7.

    Article  Google Scholar 

  28. Otani T, Kishi S. A controlled study of vitrectomy for diabetic macular edema. Am J Opthalmol. 2002;134:214–9.

    Article  Google Scholar 

  29. Lewis H, Abrams GW, Blumenkranz MS, Campo RV. Vitrectomy for diabetic macular traction and edema associated with posterior hyaloidal traction. Ophthalmology. 1992;99:753–9.

    Article  CAS  PubMed  Google Scholar 

  30. Figueroa MS, Contreras I, Noval S. Surgical and anatomical outcomes of pars plana vitrectomy of diffuse nontractional diabetic macular edema. Retina. 2008;28:420–6.

    Article  PubMed  Google Scholar 

  31. Massin P, Duguid G, Erginay A, Haouchine B, Gaudric A. Optical coherence tomography for evaluating diabetic macular edema before and after vitrectomy. Am J Opthalmol. 2003;135:169–77.

    Article  Google Scholar 

  32. Funatsu H, Yamashita H, Ikeda T, Mimura T, Eguchi S, Hori S. Vitreous levels of interleukin-6 and vascular endothelial growth factor are related to diabetic macular edema. Ophthalmology. 2003;110:1690–6.

    Article  PubMed  Google Scholar 

  33. Lee DH, Kim JT, Jung DW, Joe SG, Yoon YH. The relationship between foveal ischemia and spectral-domain optical coherence tomography findings in ischemic diabetic macular edema. Invest Ophthalmol Vis Sci. 2013;7(54):1080–5.

    Article  Google Scholar 

  34. Stefansson E, Landers 3rd MB, Wolbarsht ML. Vitrectomy, lensectomy, and ocular oxygenation. Retina. 1982;2:159–66.

    Article  CAS  PubMed  Google Scholar 

  35. Stefansson E, Landers 3rd MB, Wolbarsht ML. Increased retinal oxygen supply following pan-retinal photocoagulation and vitrectomy and lensectomy. Trans Am Ophthalmol Soc. 1981;79:307–34.

    CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Hyogo Prefectural Amagasaki General Medical Center (AGMC), Amagasaki, Hyogo, Japan

    Takafumi Hirashima MD, Masanori Hagihara MD & Hideyasu Oh MD, PhD

Authors
  1. Takafumi Hirashima MD
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  2. Masanori Hagihara MD
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  3. Hideyasu Oh MD, PhD
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Correspondence to Hideyasu Oh MD, PhD .

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Editors and Affiliations

  1. Jasne Blonia Ophthalmic Clinic, Lodz, Poland

    Zofia Michalewska

  2. Jasne Blonia Ophthalmic Clinic, Lodz, Poland

    Jerzy Nawrocki

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Hirashima, T., Hagihara, M., Oh, H. (2017). Diabetic Macular Edema. In: Michalewska, Z., Nawrocki, J. (eds) Atlas of Swept Source Optical Coherence Tomography . Springer, Cham. https://doi.org/10.1007/978-3-319-49840-9_12

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  • DOI: https://doi.org/10.1007/978-3-319-49840-9_12

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