Restoration of Foveal Bulge after Resolution of Diabetic Macular Edema with Coexisting Serous Retinal Detachment.

Yijun Hu,Honghua Yu,Pingting Zhong,Baoyi Liu,Qiaowei Wu,Yu Xiao,Xiaomin Zeng,Manqing Huang,Cong Li,Ying Fang,Qingsheng Peng,Xiaohong Yang,Tao Li

doi:10.1155/2020/9705786

Abstract

Purpose To evaluate the impact of restoration of foveal bulge (FB) in optical coherence tomography (OCT) images on visual acuity after resolution of diabetic macular edema with coexisting serous retinal detachment (SRD-DME). Methods A total of 52 eyes with resolved SRD-DME and an intact ellipsoid zone at the central fovea were included. All eyes underwent best-corrected visual acuity (BCVA) examination and OCT scanning at baseline and follow-up visits (1, 3, and 6 months). The eyes were divided into two groups according to the presence of FB at 6 months. BCVA, central foveal thickness (CFT), height of SRD (SRDH), outer nuclear layer (ONL) thickness, photoreceptor inner segment (PIS), and outer segment (POS) length were compared between the two groups. Results A FB was found in 25 of 52 (48%) eyes at 6 months. The FB (+) group had lower SRDH at baseline, and better BCVA, longer POS length at 6 months (all P < 0.05). There was no significant difference in the CFT, ONL thickness, and PIS length at 6 months between the two groups (all P > 0.05). More eyes in the FB (+) group had complete SRD resolution at 1 month (P = 0.009) and 3 months (P = 0.012). Eyes with complete SRD resolution at 1 month (P = 0.009) or 3 months (P = 0.012) were more likely to have a FB at 6 months. Conclusions The Presence of the FB is associated with better BCVA after resolution of SRD-DME. Eyes with lower baseline SRDH or faster SRD resolution are more likely to have a FB at 6 months.

Highlights

Retinal detachment (RD) refers to a clinical situation where the neurosensory retina is detached from the underlying retinal pigment epithelium (RPE) [1]
All the patients received comprehensive baseline ophthalmologic examinations including best-corrected visual acuity (BCVA) with decimal chart which was converted to the logarithm of minimal angle of resolution (LogMAR) and the Snellen visual acuity, slit-lamp biomicroscope anterior segment and fundus examination, intraocular pressure (IOP) measurement, and baseline since diagnosis of DM (SD)-optical coherence tomography (OCT) scanning (Spectralis; Heidelberg Engineering, Heidelberg, Germany)
The foveal bulge (FB) (+) group had better BCVA and longer POS length at 6 months compared to the FB (-) group (Table 2)

Summary

Introduction

Retinal detachment (RD) refers to a clinical situation where the neurosensory retina is detached from the underlying retinal pigment epithelium (RPE) [1]. Separation of the neurosensory retina from the RPE leads to deprivation of nutrition and oxygen supplies to the outer retina which in turn causes photoreceptor apoptosis and visual loss [1,2,3]. Successful reattachment of the neurosensory retina is essential for vision recovery in RD patients. Retinal reattachment allows restoration of blood supply to the outer retina and regeneration of the photoreceptors, and the patients’ visual acuity is recovered . Better visual recovery is usually closely correlated to an intact EZ at the fovea after retinal reattachment [6, 7]. Visual acuity in some RRD patients after successful retinal reattachment is still

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Conclusion