Differential diagnosis (occlusion and unocclusal kind) of complicated and diffuse diabetic macular edema with optical coherence tomography method in patients with diabetes type II


  • O. V. Zborovskaya
  • N. I. Preuss




diabetic macular edema, OCT


Introduction. Diabetic macular edema (DME) is a common manifestation of diabetic retinopathy and an important cause of visual impairment in people with diabetes. DME is the most common cause of decreased vision in patients with diabetes. It can accompany any stage of the disease and occurs on average 10% of patients with diabetes. In this case, due to structural changes in the endothelium of retinal vessels violation of the retinal barrier increased permeability of blood vessels wall and fluid accumulation in the intercellular space retinal optical coherence tomography (OCT) is a method of diagnostic morphological structure of the retina and allows high precision of the DME diagnose, assess the severity and observe the dynamics.

Materials and methods. During the work general ophthalmic examination, OCT,  PAH and immunological studies were performed in all patients. Total 64 patients (128 eyes), including 28 women (43.8%) and 36 men (56.3%), whose average age was '58 (SD 10), 24 to 78 years with diabetes type II diabetic macular edema of various kinds took part in the study. Diffuse (occlusal and unocclusal kind ) and complicated (occlusal and unocclusal ) DME were studied. Diffuse occlusal DME was diagnosed in 33 cases, diffuse unocclusal DME – in 35 cases, complicated occlusal DME - in 28 cases, complicated unocclusal DME - in 32. Statistical analysis was performed in the program MedCalc 9.0.

Results and Discussion: In this clinical study there is a clear pattern between the type and the presence of DME.

Conclusions: We can talk about the use of the criterion of the presence or absence of RPE detachment to differentiate species (occlusion or unocclusual) diffuse and complicated DME in patients with diabetes type II.


Дедов И.И. Проект «Консенсус совета экспертов Российской ассоциации эндокринологов (РАЭ) по инициации и интенсификации сахароснижающей терапии сахарного диабета 2-го типа» / И.И. Дедов, М.В. Шестакова, А.С. Аметов // Cахарный диабет. – 2011. – №1. – С. 95–105.

Науменко В.А. Эффективность нового метода диагностики и лазерного лечения отечных форм диабетической макулопатии: дис. ... канд. мед. наук: 14.01.18 / В.А. Науменко. – Одесса, 2004. – 63 с.

Оптическая когерентная томография в диагностике глазных болезней / Под ред. А.Г. Щуко. – М.: ГЕОТАР Медиа, 2010. – 128с.

Пасєчнікова Н.В. Затвердження тактики лікування діабетичного макулярного набряку / Н.В. Пасєчнікова, В.О. Науменко// Мат. XII з’їзду офтальмологів України, 26–28 травня 2010 р. – Одеса, 2010. – С. 359.

Реброва О.Ю. Статистический анализ медицинских данных/ О.Ю. Реброва – М.: Медиа Сфера, 2003. – 312 с.

American Diabetes Association: Diabetes Retinopathy. // Diabetes Care. – 2002. – Vol. 25, №1. – Р. 590–593.

Antcliff R.J. The pathogenesis of edema in diabetic maculopathy/ R. J. Antcliff, J. Marshall // Semin. Ophthalmol. – 1999. – Vol. 14. – P. 223–232.

Fercher A.F. Eye-length measure ment by interferometry with partially coherent light/A.F. Fercher, K. Mengedoht, W. Werner // Opt.Lett. – 1988. – Vol. 13. – P. 186–188.

Gass J.D. Macular diseases, diagnostic and treatment / J.D. Gass. – St. Louis, 1997.

Gass J.D. A clinical, fluorescein angiographic and electron microscopic correlation of cystoid macular edema / J.D.Gass, D.A. Anderson, E.B. Davis // Am. J. Ophthalmol. – 1985. – Vol. 100. – P. 82–86.

Gaudric A. Les classifi cations de la retinopathie diabetique / A. Gaudric, G. Coscas // Rev. Chibret. Simposium international sur la retinopathie diabetique. – 1985. – P. 89–108.

Klein R. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. IV^ Diabetic macular edema / R. Klein, B. E. Klein, S. E. Moss [et al.] // Ophthalmology. – 1984. – Vol. 91. – P.1464–1474.

Moss S.E. The 14-year incidence of visual loss in a diabetic population / S.E. Moss, R. Klein, B.E. Klein // Ophthalmology. – 1998. – Vol. 105. –P. 998–1003.

Nguyen Q.D. Vascular endothelium growth factor is a critical stimulus for diabetic macular edema / Q.D Nguyen, S.M. Shah, J.S. Heier [et al.] // Am. J. Ophthalmol. – 2006. – Vol. 142. – P. 961–9697.

How to Cite

Zborovskaya OV, Preuss NI. Differential diagnosis (occlusion and unocclusal kind) of complicated and diffuse diabetic macular edema with optical coherence tomography method in patients with diabetes type II. Zaporozhye Medical Journal [Internet]. 2013Nov.13 [cited 2024Jul.17];15(5). Available from: http://zmj.zsmu.edu.ua/article/view/18885



Original research