Disruption of photoreceptor layer related to poor visual acuity

Fort Lauderdale, FL-Spectral-domain optical coherence tomography (SD-OCT) identified disruption of the photoreceptor layer as highly associated with poor visual acuity outcomes in patients with resolved diabetic macular edema (DME), according to Ahmed Soliman, MD.

“The visual acuity has only a modest correlation with the macular center subfield thickness on OCT,” said Dr. Soliman, of Joslin Diabetes Center, Harvard Medical School, Boston. “We looked for other retinal parameters on SD-OCT that were better correlated with the visual acuity.”

Dr. Soliman and his associates evaluated 66 eyes of 43 patients (mean age, 60 years; 60% with type 2 diabetes) and divided the eyes into four groups, those with current macular edema and good or reduced visual acuity and those with resolved macular edema and good or reduced visual acuity. The patients were evaluated using SD-OCT (Heidelberg Engineering).

“In eyes with current center-involved DME, reduced visual acuity was associated with increased central subfield thickness, the presence of perifoveal layer disorganization, cysts, and epiretinal membranes in an unadjusted model,” he said. “In a multivariable adjusted model, central subfield thickness and perifoveal layer disorganization were significantly associated with decreased visual acuity.”

Perifoveal layer disorganization was associated with reduced visual acuity across the four patient groups, and in patients with resolved macular edema, about 85% of those with reduced visual acuity had perifoveal layer disorganization compared with 16% of those good visual acuity.

“Visual loss in this study population was primarily associated with perifoveal layer disorganization particularly in eyes with resolved edema,” Dr. Soliman concluded. “Perifoveal layer disorganization might be used to predict functional outcomes in patients with center-involved DME.”

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