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

ABSTRACT

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. 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]. 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]. 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