Diurnal variation in retinal thickening measurement by optical coherence tomography in center-involved diabetic macular edema.
ABSTRACT To evaluate diurnal variation in retinal thickness measured with optical coherence tomography (OCT) in patients with center-involved diabetic macular edema.
Serial OCT3 measurements were performed in 156 eyes of 96 subjects with clinically diagnosed diabetic macular edema and OCT central subfield retinal thickness of 225 microm or greater at 8 am. Central subfield thickness was measured from OCT3 retinal thickness maps at 6 points over a single day between 8 am and 4 pm. A change in central subfield thickening (observed thickness minus mean normal thickness) of at least 25% and of at least 50 microm at 2 consecutive points or between 8 am and 4 pm was considered to have met the composite outcome threshold.
At 8 am, the mean central subfield thickness was 368 microm and the mean visual acuity was 66 letters (approximately 20/50). The mean change in relative central subfield retinal thickening between 8 am and 4 pm was a decrease of 6% (95% confidence interval, -9% to -3%) and the mean absolute change was a decrease of 13 microm (95% CI, -17 to -8). The absolute change was significantly greater in retinas that were thicker at 8 am (P<.001) but the relative change was not (P = .14). The composite threshold of reduction in central subfield thickening (as defined above) was observed in 5 eyes of 4 subjects (3% of eyes; 95% CI, 1% to 8%) while 2 eyes of 2 subjects (1%; 95% CI, 0% to 5%) had an increase in central subfield thickening of this same magnitude. The maximum decrease was observed at 4 pm in all 5 eyes.
Although on average there are slight decreases in retinal thickening during the day, most eyes with diabetic macular edema have little meaningful change in OCT central subfield thickening between 8 am and 4 pm.
Article: Cyclic macular edema.[show abstract] [hide abstract]
ABSTRACT: Three patients with macular edema noted that their vision improved during the course of the day. In one patient, a 25-year-old man, visual acuity improved from 20/40 to 20/30; in the second, a 53-year-old woman, it improved from 20/60 to 20/40; in the third, a 30-year-old man, it improved from 20/25 to 20/20. The Rayleigh match showed a wider divergence in color matches to test wavelengths during the morning hours in one patient. The Stiles-Crawford effect was abnormal in all three patients but showed no cyclic pattern. All three patients had difficulty with Arden plates, but no cyclic pattern was apparent. The cyclic change in visual acuity could not be corrected by a change in refraction and may have been the result of a change in the macular edema.American Journal of Ophthalmology 12/1982; 94(5):664-9. · 4.22 Impact Factor