Elsevier

Ophthalmology

Volume 114, Issue 1, January 2007, Pages 104-107
Ophthalmology

Original Article
Correlation between Optical Coherence Tomography and Fluorescein Angiography Findings in Diabetic Macular Edema

https://doi.org/10.1016/j.ophtha.2006.06.044Get rights and content

Objective

To report the relationship between the findings of third-generation optical coherence tomography (OCT) and fluorescein angiography (FA) in eyes with diabetic macular edema (DME).

Design

Small case series.

Participants

Four eyes with DME.

Methods

We compared findings from late-phase FA with corresponding cross-sectional OCT images using 5-mm-long horizontal and vertical scans.

Main Outcome Measures

Fluorescein angiography and OCT findings in DME.

Results

Fluorescein angiography showed dye pooling within the cystic spaces with a petalloid pattern in the foveal area in all eyes; 3 eyes had cystic spaces primarily in the outer plexiform layer (OPL) on OCT. In 16 perifoveal areas in 4 eyes, FA showed hyperfluorescence with a honeycomb pattern in 7 areas, petalloid pattern in 3, and diffuse pattern in 3. The remaining 3 perifoveal areas had no hyperfluorescence. Optical coherence tomography showed that the perifoveal areas with a honeycomb pattern of hyperfluorescence had not only swelling of the OPL but also cystoid spaces located in the inner nuclear layer (INL). The perifoveal areas with no honeycomb pattern but petalloid or diffuse hyperfluorescence had only retinal swelling of the OPL. In the remaining 3 perifoveal areas without hyperfluorescence, OCT showed almost normal retinal structures.

Conclusions

Diabetic macular edema typically showed 2 patterns of dye pooling on late-phase FA (i.e., petalloid in the fovea and honeycomb in the perifoveal area). The dye pooling corresponded to large cystic spaces in the OPL, and the honeycomb pattern to small cystic spaces in the INL.

Section snippets

Patients and Methods

Four eyes of 4 patients with diabetes and DME (4 men) ages 58 (patient 1), 56 (patient 2), 39 (patient 3), and 57 years (patient 4) were included. In addition to a routine ophthalmic examination, FA and Stratus OCT were performed in all eyes.

We compared the late-phase angiograms (10–12 minutes after injection) with the corresponding cross-sectional OCT images. All eyes were examined using 5.0-mm scan lengths that included the fovea (1.8 mm in diameter) and the adjacent perifoveal region (1.6 mm

Results

The late-phase fluorescein angiograms of the foveal area showed a petalloid pattern of hyperfluorescence in all eyes, of which 3 (patients 1, 2, and 3) had cystic spaces mainly in the OPL on OCT. The remaining eye (patient 4) had no cystic spaces but retinal swelling in the OPL on OCT. In 16 perifoveal areas in 4 eyes, FA showed a honeycomb pattern of hyperfluorescence in 7 areas (patients 2 and 3), petalloid pattern in 3 areas (patient 4), and diffuse pattern in 3 areas (patients 1 and 2). The

Discussion

Our comparative study using FA and OCT for DME revealed that dye pooling with a petalloid pattern in the foveal area corresponded to cystic spaces in the OPL, and a honeycomb pattern corresponded to cystic spaces in the INL in the perifoveal area. In this series, FA findings did not always correspond to those of OCT. In the foveal area, 3 of 4 eyes with a petalloid pattern of hyperfluorescence had cystic spaces in the OPL, whereas 1 eye (patient 4) had no cystic spaces but retinal swelling.

References (14)

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