빛간섭단층촬영에 따른 당뇨황반부종의 형태학적 분류와 치료 후 임상경과

Analysis of Optical Coherence Tomographic Patterns and Clinical Courses in Diabetic Macular Edema after Treatment

Purpose: To analyze the optical coherence tomographic patterns and clinical courses of patients with diabetic macular edema (DME) after treatment. Methods: The charts of 65 patients with DME were retrospectively reviewed. Baseline optical coherence tomographic patterns of DME were categorized into the 4 groups: group 1 (9 eyes, 13.8%) showed diffuse retinal thickening, group 2 (21 eyes, 32.3%) had cystoid macular edema (CME), group 3 (13 eyes, 20.0%) demonstrated serous retinal detachment (SRD) and group 4 (22 eyes, 33.9%) had combined CME and SRD. Treatments for DME included intravitreal bevacizumab/ triamcinolone injection, focal laser photocoagulation and vitrectomy. During 12 months of follow-up, changes in the patterns of DME were assessed. Additionally, the central retinal thickness (CRT) and best-corrected visual acuity (BCVA) were measured at baseline, 6 and 12 months. Results: During 12 months of follow-up, 21 eyes (32.3%) showed changes in the DME pattern: 2 eyes (22.2%) in group 1, 3 (14.3%) in group 2, 4 (30.8%) in group 3 and 12 (54.5%) in group 4. A significantly greater proportion of eyes with changes in DME pattern underwent vitrectomy compared with those without changes in DME pattern (p = 0.012). There was a significant difference in CRT among the 4 groups; group 4 demonstrated the largest CRT at baseline, 6 and 12 months (p < 0.001, 0.002 and 0.029, respectively). However, there were no significant differences in BCVA among the 4 groups at baseline, 6 or 12 months (p = 0.879, 0.375 and 0.246, respectively). Conclusions: Clinical courses varied according to the tomographic patterns of DME after treatment, and the poorest anatomic outcome was found in group 4. Change in tomographic pattern of DME was correlated with the treatment of DME, which might suggest a poorer outcome in those patients than in the patients who maintained their DME patterns. J Korean Ophthalmol Soc 2014;55(2):222-229