FLOURESCEIN FUNDUS ANGIOGRAPHY VERSUS OPTICAL COHERENCE TOMOGRAPHY IN DIABETIC MACULAR EDEMA

Abstract

Background: Diabetic maculopathy is the leading cause of visual loss in diabetic patients. The pathogenesis is not fully understood and a satisfactory therapy is currently not available. The most common tools to diagnose diabetic retinopathy and diabetic macular edema are flourscien fundus angiography (FA) and optical coherene tomography (OCT). Objective: To compare between the assessment of diabetic macular edema by Fluorescein fundus angiography and by Optical coherence tomography in the same patients. Patients and Methods: Forty eyes were included in the study with non-proliferative diabetic retinopathy with maculopathy those met the inclusion criteria. Patients were fully evaluated including history, examination and investigations. Investigations used Optical Coherence Tomography and Flouresien Fundus Angiography. Study setting at Memorial Institute of Ophthalmic Research (MIOR) and Al-Azhar University Hospitals from March 2019 to October 2019. Results: The distribution of FA patterns showed diffuse leakage at macula as the most common pattern seen in 60% of eyes followed by focal leakage at macula seen in 27.5% of eyes, and combined (focal and diffuse leakage at macula) was seen in 12.5% of eyes. Eyes with focal leakage were more likely to have CME, whereas eyes with diffuse leakage were more likely to have serous foveal detachment and combined pattern on OCT show cystoid macular edema with serous foveal detachment. Conclusion: FA is known to be a sensitive method for qualitative assessment of fluid leakage in diabetic macular edema; however, actual macular thickening assessed by OCT is better correlated with the loss of visual acuity. Furthermore, FA is an invasive procedure with side effects ranging from nausea to its rare complication of anaphylaxis and death. OCT is noninvasive, comfortable, safe, fast and can be repeated as often as required and offers an alternative to FA in the follow up of changes in retinal thickness after laser photocoagulation and intra-vitreal steroid injection. However, FA is still essential for the assessment of the foveal perfusion state, which cannot be demonstrated by the OCT.