PURPOSE:To study the relationship between intraretinal optical coherence tomography (OCT) and fluorescein angiography (FA) findings in eyes with diabetic macular oedema (DMO). METHODS:We carried out a retrospective observational case series. Thirty eyes with previously untreated DMO underwent FA and OCT. The same ETDRS template was overlaid on the FA images in order to compare OCT and FA. Transfoveal linear high-resolution OCT scans (at the 0- and 90-degree meridians) and FA pictures were compared according to the ETDRS rings. RESULTS:Six distinct patterns of intraretinal changes in OCT correlated with changes in FA: (a) focal angiographic leakage did not correspond to any obvious intraretinal abnormality in OCT in four eyes; (b) localized thickening of the outer nuclear layer in OCT corresponded to focal leaking microaneurysm (focal oedema) in FA in 11 eyes; (c) diffuse thickening of the outer nuclear layer in OCT corresponded to diffuse angiographic leakage in 21 eyes; (d) cystoid expansion of the outer nuclear layer was found in seven eyes with a petaloid angiographic pattern of leakage; (e) cystoid expansion of the inner nuclear layer was found in relation to honeycomb angiographic oedema in five eyes, and (f) serous detachment of the fovea in OCT did not correspond to any distinct finding in FA in four eyes. CONCLUSIONS:Intraretinal abnormalities found in OCT correlate systemically with changes in FA. Very early DMO morphological changes may be seen better with FA than with OCT. Serous detachment of the fovea is seen in OCT, but not in FA. The combination of OCT and FA is useful in facilitating understanding of the pathophysiological changes that occur in DMO.

译文

目的:研究糖尿病性黄斑水肿(DMO)眼睛的视网膜内光学相干断层扫描(OCT)与荧光素血管造影(FA)结果之间的关系。
方法:我们进行了回顾性观察病例系列。 30眼未经治疗的DMO接受了FA和OCT。为了比较OCT和FA,将相同的ETDRS模板覆盖在FA图像上。根据ETDRS环比较经小凹的线性高分辨率OCT扫描(在0度和90度子午线)和FA图片。
结果:OCT的视网膜内变化的六个不同模式与FA的变化相关:(a)四只眼中OCT的局灶性血管造影渗漏并不与任何明显的视网膜内异常相对应; (b)在11眼中,OCT中外核层的局部增厚对应于FA中的局灶性漏出性微动脉瘤(局灶性水肿); (c)OCT外核层的弥漫性增厚对应于21眼的弥散性血管造影渗漏; (d)在七只眼中发现了外核层的囊状扩张,并有花瓣状的血管造影样渗漏; (e)在五只眼中发现了与蜂窝状血管造影水肿相关的内核层的囊状扩张,并且(f)在四只眼中,OCT中央凹的浆液性脱离并不对应于FA中的任何明显发现。
结论:OCT中发现的视网膜内异常与​​FA的改变有系统的相关性。用FA可以比用OCT更好地观察DMO的早期形态变化。在OCT中可见中央凹的浆液性脱离,但在FA中未见。 OCT和FA的组合有助于促进对DMO中发生的病理生理变化的了解。

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