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목적 : To evaluate the sectoral diurnal variations of total, inner, and outer retinal thickness (RT) in diabetic macular edema (DME) using spectral domain optical coherence tomography (SD-OCT).
방법 : 20 eyes of patients with diabetic macular edema (DME) and 20 healthy subjects (controls) underwent five SD-OCT measurements of RT at 9 AM, 11 AM, 1 PM, 3 PM, and 5 PM. The inner and the outer RT in the parafoveal subfields were measured manually. Mean arterial pressure (MAP) was calculated from ambulatory arterial pressure measurement.
결과 : The inner RT did not exhibit significant diurnal variation at all of subfields. A positive correlation between MAP and RT was not found (p=0.610). In the subgroup analysis, 9 patients with a baseline foveal thickness of <300 µm showed a significant diurnal change of total and outer RT only in superior subfield. Meanwhile, 11 diabetic patients with a baseline foveal thickness of ≥300 µm demonstrated significant diurnal changes of total and outer RT in all subfields. Comparing controls, Total and outer RT decreased in superior subfield over the course of the day (p=0.016; p=0.04).
결론 : In the eyes with DME, total and outer RT decreased significantly due to gravitational shift in superior subfield while inner RT supplied by retinal vasculature did not show diurnal variation in any subfield. This means that circadian fluctuation of DME may be more influenced by postural change than hydrostatic pressure in retinal capillaries. The circadian fluctuation of RT is higher in patients with severe DME.
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