OCT and Diabetic Macular Edema

Alain Gaudric, Ramin Tadayoni, Pascale Massin (Paris)

OCT allows a precise quantification of retinal thickening in diabetic macular edema,and to disclose new subclinical features, such as shallow foveal serous detachment, or incomplete vitreofoveolar detachment. These two conditions might have an influence on visual acuity.
Foveal serous detachment is present in about 15 % of diabetic macular edema and is usually associated with a significant macular thickening.
Perifoveal vitreous detachment, characterized by the persistance of a focal vitreofoveal adhesion of a normally reflective posterior hyaloid, tends to be more frequent in eyes with diabetic macular edema (in about half the cases), than in eyes with diabetic retinopathy but without macular edema. This incomplete vitreous detachment might indicate a traction exerted on the foveal center,
which could worsen macular edema in some cases. In rare cases (only 1% of cases is our series), the partial posterior vitreous detachment is characterized by a taut, thickened an hyperreflective posterior hyaloid, adhering to the top of the elevated macula, resulting in a tractional diabetic macular edema, for which vitrectomy is highly indicated.



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