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. 2013 Sep;6(3):183-8.
doi: 10.4103/0974-620X.122275.

Communications between intraretinal and subretinal space on optical coherence tomography of neurosensory retinal detachment in diabetic macular edema

Aditi Gupta  1 , Rajiv Raman  1 , Kp Mohana  1 , Vaitheeswaran Kulothungan  2 , Tarun Sharma  1
Affiliations

Communications between intraretinal and subretinal space on optical coherence tomography of neurosensory retinal detachment in diabetic macular edema

Aditi Gupta et al. Oman J Ophthalmol. 2013 Sep.

Abstract

Background: The pathogenesis of development and progression of neurosensory retinal detachment (NSD) in diabetic macular edema (DME) is not yet fully understood. The purpose of this study is to describe the spectral domain optical coherence tomography (SD-OCT) morphological characteristics of NSD associated with DME in the form of outer retinal communications and to assess the correlation between the size of communications and various factors.

Materials and methods: This was an observational retrospective nonconsecutive case series in a tertiary care eye institute. We imaged NSD and outer retinal communications in 17 eyes of 16 patients having NSD associated with DME using SD-OCT. We measured manually the size of the outer openings of these communications and studied its correlation with various factors. Statistical analysis (correlation test) was performed using the Statistical Package for Social Sciences (SPSS) software (version 14.0). The main outcome measures were correlation of the size of communications with dimensions of NSD, presence of subretinal hyper-reflective dots, and best-corrected visual acuity (BCVA).

Results: The communications were seen as focal defects of the outer layers of elevated retina. With increasing size of communication, there was increase in height of NSD (r = 0.701, P = 0.002), horizontal diameter of NSD (r = 0.695, P = 0.002), and the number of hyper-reflective dots in the subretinal space (r = 0.729, P = 0.002). The minimum angle of resolution (logMAR) BCVA increased with the increasing size of communications (r = 0.827, P < 0.0001).

Conclusions: Outer retinal communications between intra and subretinal space were noted in eyes having NSD associated with DME. The size of communications correlated positively with the size of NSD and subretinal detachment space hyper-reflective dots, and inversely with BCVA.

Keywords: Diabetic macular edema; neurosensory detachment; outer retinal communications; spectral domain optical coherence tomography; subretinal detachment space hyper-reflective dots.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Fundus (left), SD-OCT (center), and magnified (right) images of eyes 1-3 having NSD in DME. Small communications between intraretinal fluid pockets and subretinal space (white arrows) are associated with small NSDs and none or few hyper-reflective dots in subretinal detachment space
Figure 2
Figure 2
Fundus (left), SD-OCT (center), and magnified (right) images of eyes 4-6 having NSD in DME. With increase in size of communications (white arrows), height of the associated NSDs increase; however, the subretinal detachment space appears clear without any hyper-reflective dots
Figure 3
Figure 3
Fundus (left), SD-OCT (center), and magnified (right) images of eyes 7-9 having NSD in DME. Intermediate-sized communications (white arrows) larger than those in eyes 1-6 are seen. With an increase in size of communications, a few hyper-reflective dots appear in the subretinal space
Figure 4
Figure 4
Fundus (left), SD-OCT (centre) and magnified (right) images of eyes 10-12 having NSD in DME. As size of intermediate-sized communications (white arrows) increase further, many hyper-reflective dots are now observed in the subretinal space. Note the presence of two communications in eye 12
Figure 5
Figure 5
Fundus (left), SD-OCT (center), and magnified (right) images of eyes 13- 15 having NSDin DME. Large-sized communications (white arrows) are seen, with increased height and horizontal diameter of associated NSDs and many hyper-reflective dots in the subretinal detachment space
Figure 6
Figure 6
Fundus (left), SD-OCT (center), and magnified (right) images of eyes 16-17 having NSD in DME. Large-sized communications (white arrows) are seen with larger NSDs and greater number of hyper-reflective dots in the subretinal space. All eyes are numbered by increasing size of communications
See this image and copyright information in PMC

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