uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Macular edema and visual outcome following cataract surgery in patients with diabetic retinopathy and controls
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
Show others and affiliations
2011 (English)In: Graefe's Archives for Clinical and Experimental Ophthalmology, ISSN 0721-832X, E-ISSN 1435-702X, Vol. 249, no 3, 349-359 p.Article in journal (Refereed) Published
Abstract [en]

Cystoid macular edema (CME) is a well-known complication after cataract surgery, and diabetic retinopathy is reported to be an important risk factor for impaired visual recovery. In this prospective study, we compared visual outcome 6 months after surgery in eyes with moderate retinopathy and no previous ME with a control group, and observed the incidence of ME seen on fluorescein angiography (FA) and optical coherence tomography (OCT).

Thirty-four patients with type-2 diabetes and 35 controls were enrolled. Best-corrected visual acuity (VA) letters ETDRS was measured pre-op, at day 7, week 6 and month 6. FA performed pre-op and at week 6 was divided into three leakage patterns. OCT performed pre-op, at week 6 and month 6 was qualitatively divided into three types. Macular thickness was measured in three circular fields (central subfield, inner and outer circle) from the macular maps.

There was no statistically significant difference in VA before surgery, at day 7 or at 6 months, but at 6 weeks there was a significant difference with lower VA in the diabetic group. Six percent of control and 12% of diabetic eyes developed a clinical CME defined as a loss of > 5 letters between day 7 and week 6. Incidence of FA leakage was 23% in control and 76% in diabetic eyes. At 6 weeks, 20% of control and 44% of the diabetic eyes had qualitative changes on OCT. A statistically significant increase in thickness was observed for all three macular areas in both groups, part of it remaining at 6 months. There were, however, no differences in central macular thickness between the groups at any visit. Retinal thickening had poor correlation with VA.

The final visual outcome in eyes with mild to moderate retinopathy, without previous ME, is as good as in normal eyes, but an increased frequency of macular changes may protract recovery of full vision. Changes on OCT or FA are often seen without any obvious effect on VA. OCT is as good as FA at detecting a clinical CME, and is the technique recommended for follow-up before FA is considered.

Place, publisher, year, edition, pages
2011. Vol. 249, no 3, 349-359 p.
Keyword [en]
Visual outcome, Phacoemulsification, Cystoid macular edema, Optical coherence tomography, Fluorescein angiography, Sub-clinical macular thickening
National Category
Medical and Health Sciences
Research subject
Ophtalmology
Identifiers
URN: urn:nbn:se:uu:diva-128901DOI: 10.1007/s00417-010-1484-9ISI: 000288454200003PubMedID: 20827486OAI: oai:DiVA.org:uu-128901DiVA: diva2:332284
Available from: 2010-08-03 Created: 2010-08-02 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Aspects of Optical Coherence Tomography (OCT) in Healthy Eyes and Eyes with Retinal Diseases
Open this publication in new window or tab >>Aspects of Optical Coherence Tomography (OCT) in Healthy Eyes and Eyes with Retinal Diseases
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Optical coherence tomography (OCT) is a technique in which cross-sectional images from intraocular tissue can be obtained. The quantitative and qualitative examinations are used for evaluating retinal diseases. Conventional OCT (Stratus) is mainly used, but the new Spectral domain (Cirrus) OCT, which has improved technology, may provide more reliable measurements.

The aim of the study was to collect normal values of macular thickness in children and adults and to evaluate the effect of age and/or gender, to compare measurement variability in healthy eyes and eyes with age-related macular degeneration (AMD), to compare Stratus and Cirrus OCT and to study the effect of cataract surgery on macula.

Sixty-seven healthy adults and 56 children, 30 patients with AMD, 34 patients with diabetes and cataract and 35 healthy controls were included. The quantitative maps in Stratus and Cirrus were used and manual correction of foveal location was evaluated. Qualitative OCT was compared to fluorescein angiography (FA) after cataract surgery.

The mean values of macular thickness in Stratus OCT were 207µm in adults and 204 µm in children. The measurement variability was low. Macular thickness decreased with age in adults, but not in children. No correlation with gender was found. In eyes with wet AMD, there were small differences in measurement variability comparing Stratus and Cirrus OCT. After manual correction in Cirrus OCT, the coefficients of repeatability were improved to values close to the repeatability in normal eyes. Two thirds of the diabetic and half of the control eyes showed leakage on FA after cataract surgery. Qualitative OCT corresponded poorly to FA in diabetic eyes. A thicker macula, assessed with OCT, was often observed without any obvious effect on visual acuity.  OCT was as good as FA in revealing clinically relevant changes in macula after surgery, and was the technique recommended for follow-up.

Place, publisher, year, edition, pages
Uppsala: Acta Universitas Upsaliensis, 2010. 53 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 580
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
urn:nbn:se:uu:diva-129163 (URN)978-91-554-7851-3 (ISBN)
Public defence
2010-09-17, Grönwallsalen, Akademiska sjukhuset, entrance 70, ground floor, 75185, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2010-08-27 Created: 2010-08-05 Last updated: 2012-11-20

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Authority records BETA

Eriksson, Urban

Search in DiVA

By author/editor
Eriksson, Urban
By organisation
Ophthalmology
In the same journal
Graefe's Archives for Clinical and Experimental Ophthalmology
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 510 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf