A Pathogenetic Classification of Diabetic Macular Edema

M Battaglia Parodi, P Iacono, M Cascavilla, I Zucchiatti, F Bandello

Research output: Contribution to journalArticle

Abstract

Purpose: The aim of this study was to define a new pathogenetic classification of diabetic macular edema (DME) and to present the results of its application in common clinical practice. Methods: One hundred and seventy-seven consecutive patients with center-involving DME, central retinal thickness (CRT) ≥250 µm, were prospectively enrolled. A complete ophthalmological examination included best-corrected visual acuity (BCVA) assessment, fundus photography, and spectral-domain optical coherence tomography (OCT). The DME classification was broken down into 4 categories, combining the presence of retinal thickening with the presence/absence of visible vascular dilations and OCT-detectable macular traction. The OCT parameters included were as follows: CRT, subretinal fluid, intraretinal cysts, and hyper- reflective foci (HF). Results: Four subtypes of DME were identified: vasogenic (131 eyes, DME with vascular dilation), nonvasogenic (46 eyes, DME without vascular dilation), tractional (11 eyes), and mixed DME (13 eyes). Vasogenic DME was the pattern mainly represented in each subclass of CRT ( < 300, 300–400, and > 400 µm), with tractional DME observed especially with CRT > 400 µm. Internal and external cysts and a greater presence of hard exudates were predominantly found in vasogenic DME, whereas HF was equally distributed in the 4 DME subgroups. Conclusion: The study offers a new pathogenetic classification able to detect significant differences among DME subtypes. A tailored therapeutic approach could take into consideration specific changes associated with the different DME subtypes. © 2018 S. Karger AG, Basel
Original languageEnglish
Pages (from-to)23-28
Number of pages6
JournalOphthalmic Research
Volume60
Issue number1
DOIs
Publication statusPublished - 2018

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Macular Edema
Optical Coherence Tomography
Blood Vessels
Dilatation
Cysts
Subretinal Fluid
Photography
Traction
Exudates and Transudates
Visual Acuity

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A Pathogenetic Classification of Diabetic Macular Edema. / Battaglia Parodi, M; Iacono, P; Cascavilla, M; Zucchiatti, I; Bandello, F.

In: Ophthalmic Research, Vol. 60, No. 1, 2018, p. 23-28.

Research output: Contribution to journalArticle

Battaglia Parodi, M ; Iacono, P ; Cascavilla, M ; Zucchiatti, I ; Bandello, F. / A Pathogenetic Classification of Diabetic Macular Edema. In: Ophthalmic Research. 2018 ; Vol. 60, No. 1. pp. 23-28.
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