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Objective: To investigate the changes and relation between macular morphology and macular visual function in different degrees of diabetic macular edema., Methods: Seventy-eight eyes of 41 diabetic retinopathy patients were included and graded for diabetic macular edema as follows:31 were graded as no macular edema (NE), 26 as non-clinically significant macular edema (NCSME), and 21 as clinically significant macular edema (CSME). Best corrected visual acuity, macular sensitivity, and macular thickness of all included eyes were examed and quantified. Macular sensitivity and retinal fixation were investigated with MP-1 microperimetry. Optical coherence tomography (OCT) was used to quantify macular thickness., Results: Macular thickness significantly increased and macular sensitivity markedly decreased from the NE to the CSME group (P < 0.01), Visual acuity obviously decreased in the CSME group (P < 0.01) compared to the NE and NCSME group, but there was no statistical difference between the NE group and NCSME group. Retinal fixation type was not significantly different among three groups. Visual acuity and macular sensitivity correlated significantly in these three groups (r = -0.751, P < 0.01; r = -0.583, P < 0.01; r = -0.679, P < 0.01). The correlations were noted between retinal sensitivity and macular thickness as well as between visual acuity and macular thickness in the CSME group (r = -0.465, P < 0.05; r = 0.599, P < 0.01), but not in the NE group or in the NCSME group., Conclusions: Patients will have retinal morphologic and functional changes in early stage of DME, both of which are significantly related as the disease develops. MP-1 microperimetry proved to be consistent with VA in the evaluation of visual function, and may be more sensitive to investigate the changes of macular visual function in the early stage of macular edema.

Objective: To investigate the characters of multifocal electroretinogram (mfERG) in different grades of diabetic macular edema defined by optical coherence tomography (OCT)., Methods: MfERG and OCT were performed in 57 eyes of diabetic macular edema (DME) patients and 35 eyes of the control group. According to the macular thickness measured by OCT, eyes with DME were divided into three groups: mild, moderate and severe DMEs., Results: In mild DME, the response densities of N(1) were attenuated in ring 4[(14.67 ± 4.91) nV×deg(-2)] to ring 5 [(11.65 ± 3.89) nV×deg(-2)] respectively (t = 2.179, 2.529; P < 0.05). The latencies of P(1) was prolonged significantly in ring 3 [(40.61 ± 4.10) ms] (t = -2.133, P < 0.05). In moderate DME, the response densities of P(1) and N(1) were attenuated in ring 1 [(149.50 ± 29.01) nV×deg(-2)], ring 2 [(59.33 ± 25.96) nV×deg(-2)], ring 3 [(41.83 ± 9.78) nV×deg(-2)], and ring 5 [(22.00 ± 5.52) nV×deg(-2)] respectively (t = 3.610, 2.168, 2.627, 3.445; P < 0.05). The latencies of P(1) and N(1) were prolonged significantly in ring 3 [(42.86 ± 4.72) ms], ring 4 [(44.33 ± 5.56) ms], ring 5 [(46.31 ± 4.72) ms] (t = -3.150, -3.210, -3.968; P < 0.05) and ring 3 [(23.05 ± 3.06) ms], ring 4 [(22.41 ± 3.36) ms] (t = -2.845, -2.098; P < 0.05) respectively. In severe DME. The response densities of P(1) and N(1) were attenuated in ring 1 [(110.00 ± 20.68) nV×deg(-2)], ring 2 [(62.40 ± 27.90) nV×deg(-2)], ring 3[(39.20 ± 19.65) nV×deg(-2)], ring 5 [(21.60 ± 11.12) nV×deg(-2)] (t = 7.135, 1.782, 2.214, 2.609; P < 0.05) and ring 1 [(41.63 ± 39.17) nV×deg(-2)], ring 3 [(16.63 ± 5.81) nV×deg(-2)], ring 4 [(11.20 ± 7.42) nV×deg(-2)], ring 5 [(9.05 ± 4.63) nV×deg(-2)] (t = 2.714, 2.282, 2.736, 2.858; P < 0.05) respectively. The latencies of P(1) and N(1) were prolonged significantly in ring 1 [(35.12 ± 8.44) ms], ring 3 [(40.44 ± 2.10) ms], ring 4 [(42.80 ± 3.74) ms] (t = 3.426, -2.710, -3.120; P < 0.05) and ring 4 [(23.36 ± 4.05) ms] (t = -2.572; P < 0.05) respectively., Conclusion: As the progress of DME, the thickness of macular fovea had significant correlation with responses of multifocal electroretinogram in patients with moderate or severe DME. MfERG combined with OCT can evaluate the changes of morphology and local retinal function in macula area objectively and quantitatively.

Objective: To study the correlation of visual acuity and photoreceptor in eyes with persistent cystoid macular edema associated with branch retinal vein occlusion (BRVO)., Methods: It was a retrospective case series study.Medical records of 41 patients (41 eyes) with persistent cystoid macular edema secondary to BRVO diagnosed in Department of Ophthalmology, Peking Union Medical College Hospital from January 2008 to January 2010 were studied retrospectively. On the images obtained by spectral-domain OCT, the thickness of foveal neurosensory retina and photoreceptor layer that was beneath the foveal cystoid spaces, and the transverse length and height of foveal cystoid spaces were measured. The status of the junction between inner and outer segments of the photoreceptors (IS-OS) in the fovea was also assessed. The correlations between the parameters above and visual acuity were analyzed., Results: The average foveal neurosensory thickness was (484.71 ± 131.86) µm, the photoreceptor layer thickness was (92.04 ± 45.53) µm and the size of foveal cavity was 772.59 µm × 362.17 µm. By the Spearman's rank correlation analysis, among the parameters above, only photoreceptor layer thickness showed correlation with logMAR visual acuity (r = -0.373, P = 0.016), while other parameters showed no correlation with logMAR visual acuity. Cases were classified as three groups according to the status of IS-OS layer: continuous group (8 cases), discontinuous group (19 cases) and interrupted group (14 cases). LogMAR visual acuity in these eyes with an interrupted IS-OS line in the fovea was significantly worse than that in eyes with a continuous or discontinuous IS-OS line (P = 0.030 and 0.003, respectively). There was no statistical difference between continuous and discontinuous group (P = 0.750)., Conclusions: In patients with persistent cystoid macular edema associated with BRVO, the thickness of the foveal photoreceptor layer are positively associated with visual acuity, and the eyes without IS-OS layer have worse visual acuity than eyes with IS-OS layer.

Purpose: To evaluate the visual function in different area at retinal posterior pole for the patients with cystoid macular edema (CME)., Methods: Multifocal ERG was tested using visual evoked response imaging system (VERIS) 4.0 for 24 patients (27 eyes) with CME and 25 normal control subjects whose ages matched patient's ages, the traces and 3D function maps of first order kernel response were recorded on 103 retinal locations of 26.6 degrees X22.1 degrees visual field., Results: The latencies of N1 and P1 waves were remarkably prolonged at whole area and the 6 rings in the CME, there were statistically significant differences between the normal control group and CME (P < 0.01). Compared with normal control group, the average response densities of N1 wave at 1, 2, and 3 rings in the CME were seriously reduced (P < 0.01), but they in 4, 5 and 6 rings were not significantly changed (P > 0.05), the average response densities of P1 at whole area and the 6 rings were reduced (P < 0.05)., Conclusions: The mfERG is a promising tool to evaluate the visual function in different area at retinal posterior pole for the patients with CME. The response densities of N1 wave are better analysis index for CME.