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11 Assessing Diabetic Macular Edema with Optical Coherence Tomography |
11
Fig. 11.6 Patient with DME and disrupted inner retinal layers. Additionally, the outer retinal layers are disturbed. Only close to the optic never head (left), the outer retinal layers are visible
11.5 Prognostic Features in High-Resolution
OCT Scans
High-resolution OCT scans after intravitreal anti-VEGF treatment, in most cases, show a significant reduction in retinal thickness and normalization of the retinal layers (Fig 11.4). In patients with normal appearance ELM, the photoreceptor inner segments, the outer segments, and the RPE improvement of visual acuity after intravitreal anti-VEGF therapy has been observed in most cases. In contrast, patients with disturbed outer retinal layers on high-resolution OCT scans showed only reduction in retinal thickness, but no visual gain after intravitreal antiVEGF therapy (Fig. 11.5). Additionally, in patients with discontinuity of the inner retinal layers and disturbed outer retinal layers, we were not able to archive anatomical or visual improvements after treatment for DME (Fig. 11.6).
Summary for the Clinician
■High-resolution OCT allows one to identify prognostic features for the visual outcome after treatment for DME.
■In patients with DME, high-resolution OCT shows epiretinal membranes, subretinal fluid, intraretinal fluid accumulation, and cystoid macular edema.
■The integrity of retinal layers can be analyzed with high-resolution OCT scans.
■The presence and integrity of the ELM, the photoreceptor IS, the OS, and the RPE appears to be a good prognostic feature for the visual improvement after treatment for DME.
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