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ORIGINAL ARTICLE
Year : 2013  |  Volume : 1  |  Issue : 1  |  Page : 7-13

The relationship between photoreceptor IS/OS junction changes and visual acuity in diabetic macular edema


Department of Ophthalmology, Kaser Al Aini Medical School, Cairo University Cairo, Egypt

Correspondence Address:
Nehal M Samy El Gendy
Lecturer of Ophthalmology Cairo University, Egypt 43 Gameat El Dewal Street, Giza
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2347-5617.122817

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Purpose: To evaluate the integrity of the photoreceptor inner segment and outer segment (IS/OS) junction using spectral-domain optical coherence tomography (SD OCT) in patients with diabetic macular edema and to correlate the relationship between the integrity of the IS/OS junction and visual acuity. Design: Observational, prospective study. Materials and Methods: Forty eyes of 22 diabetic patients having diabetic macular edema. The authors performed spectral-domain optical coherence tomography in all eyes before treatment, 1month and 6 months after treatment. Central subfield thickness was defined as the average retinal thickness of the central 1-mm scanned area. The length of disruption of the inner and outer segments of the photoreceptors in the fovea were measured and graded according to their length as follows: Grade 0: Intact IS/OS line (no disruption at all), grade 1: Mild disruption (<400 μm). Grade 2: Moderate disruption (>400 μm but <1400 μm), Grade 3: Severe disruption (>1400 μm )or completely lost. Results: At the baseline, there was no correlation between the visual acuity (VA) and grade of defect (r = 0.214, P-value = 0.190). After 1 month and 6 months of treatment, there was a correlation between the VA and the grade of the defect (r = 0.538, P-value < 0.001) (r =0.603, P-value < 0.001), respectively. There was no significant association between the improvement in the IS/OS and final VA (P-value < 0.385). The mean change in VA from base line to 1 month in those who showed improvement in the defect was better than those in the nonimproved group (P-value = 0.001), and the mean change in the VA values from base line to 6 months in the improved group was better than those in the non improved group (P-value = 0.001). Conclusions: SD OCT showed that the integrity of the inner and outer segments of the photoreceptors was correlated with best-corrected visual acuity only 1 and 6 month after treatment, but not before treatment, so the correlation was not absolute.


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