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Waser, K.; Podkowinski, D.; Pretzl, J.; Mursch-Edlmayr, A. S.; Luft, N.; Ring, M.; Bolz, M. (2019): Morphologische retinale Charakteristika von Patienten mit einer Sehbehinderung infolge eines diabetischen Makulaödems. In: Ophthalmologe, Vol. 116, No. 6: pp. 563-568
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BackgroundThe World Health Organisation (WHO) defines low vision as abest corrected visual acuity (BCVA) in the better eye between 0.5logMAR and 1.3logMAR. In diabetic macular edema (DME) the correlation between retinal morphology and function is not completely understood in patients with advanced visual impairment.ObjectiveThe aim of the study was to describe the pathomorphological similarities of DME in patients with low vision and to correlate them with clinical parameters.Material and methodsOptical coherence tomography (OCT) and fluorescence angiography (FA) images were graded according to the SAVE protocol and correlated with BCVA, cataract grade and clinical parameters in order to elucidate joint features.ResultsOut of atotal collective of 65patients 24 had low vision and 18 of these 24patients (75%) showed typical signs of atrophic edema according to SAVE protocol criteria (SAVE group4);however, 6patients were afflicted with less progressive forms of DME but still suffered from low vision. Common pathomorphological findings were adiscontinuity of the ellipsoid zone (EZ;n=18), loss of pseudosepta (n=7), layer-disrupting cysts (n=7) and hard exudates (n=10).ConclusionIt is suggested that adisruption of the EZ, loss of pseudosepta and layer-disrupting cysts are signs of an advanced chronic DME causing low vision. Adefinition of characteristic pathomorphological patterns of chronic damage in OCT is important for apossible treatment discontinuation in the clinical routine.