Topography of diabetic macular oedema compared with fluorescein angiography

PURPOSE: To compare the amount and pattern of fluorescein leakage in diabetic macular oedema with the retinal thickness maps obtained with the retinal thickness analyser (RTA) and optical coherence tomography (OCT). METHODS: A consecutive series of 30 eyes from 30 patients with diabetic macular oedema was included. On fluorescein angiography (FA) the macula was analysed in 10 subfields as defined by the ETDRS. The amount and source of leakage for each field were determined. Retinal thickness was measured by OCT and RTA maps in each of the 10 fields and compared with the FA grading. RESULTS: Foveal retinal thickness on OCT was most influenced by the overall FA leakage, which was the only significant covariate on multivariate analysis. The source and amount of leakage correlated significantly with the topography of retinal thickness in the four peripheral fields between 1500 microm and 3000 microm from the macular centre (r = 0.54, p = 0.002). The mean amount and source of leakage in those fields also showed the highest correlation with central macular thickness on OCT (r = 0.46, p = 0.01). Similar results were obtained by RTA when excluding ischaemic cases (r = 0.44, p = 0.04). For both instruments, FA leakage within the four central fields < 1500 microm did not correlate significantly with retinal thickness. Thickness by OCT and RTA were highly correlated with one another for central macular measurements (r = 0.73, p < 0.001), but correlated poorly in the peripheral fields. Overall, OCT measurements correlated more highly with FA. CONCLUSIONS: Optical coherence tomography and RTA thickness measurements can be used to identify patients for further examination. Fluorescein angiography leakage in the outer ETDRS fields correlates best with central thickness and retinal thickness topography by OCT.