Diabetic Retinopathy Clinical Trial
Official title:
Reduction of Foveal Sensitivity in Eyes With Diabetic Macular Oedema, With and Without Centre Involvement
Clinically significant macular edema (CSME) is a thickening of the macula associated with
the risk of visual loss, which increases its centre is involved. Functional evaluation of
the macula relies on best corrected visual acuity; however, neural dysfunction in diabetic
eyes appears before retinal thickening and visual loss. Retinal sensitivity decreases in
eyes with CSME, but it is unknown whether it differs between eyes with and without centre
thickening.
Aim: To compare the reduction of foveal sensitivity in eyes with CSME, with and without
centre thickening.
A non-experimental, comparative, prospective, cross-sectional study was conducted. Target
population were type 2 diabetics, from Mexico City and its metropolitan area, and available
population were type 2 diabetics who attended an Ophthalmology service from a general
hospital in Mexico City, from September 2011 to May 2012.
Type 2 diabetic patients aged 30-85 years, from any gender, with central fixation, whose
ocular media allowed obtaining an adequate quality Optical Coherence Tomography, who had
CSME with focal angiographic pattern were included. Eyes with optic nerve or visual pathways
diseases or any other ocular disease that decreased Best corrected visual acuity, were
excluded. Diabetic patients without retinopathy who fulfilled the remaining selection
criteria were evaluated as the reference group.
Sixty degrees colour fundus photographs were obtained in all the patients using a Visucam
lite ocular fundus camera; in group 1 it was verified that no signs of diabetic retinopathy
existed in the photographs; CSMO was diagnosed by biomicroscopy under mydryasis, according
to the ETDRS criteria.
Retinal thickness was measured using Stratus optical coherence tomography (OCT), version
4.0.1 (Zeiss). The 6 mm fast macular map strategy was used, according to the following
standardised operating procedure: mydriasis ≥6mm, inclusion of the spherical equivalent and
anteroposterior axis, and optimisation of z axis and of polarisation; the photograph was
taken with flash between 9:00 and 11:00, using an acquisition strategy for dark irises. The
maps were obtained by the same investigator, independent from the one who evaluated the
patients clinically; any deviation of the OCT line regarding the actual retina boundary was
considered as a measurement error.
A 10° macular perimetry was obtained in all the patients, using a Humphrey field analyser
model 750i (software version 4.1); the sixteen points evaluated were arbitrarily labelled.
Retinal thickness within 3 mm from the centre of the fovea was measured in 9 fields,
according to the fast macular map.
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Observational Model: Case Control, Time Perspective: Prospective
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