24-Hour variation of optical coherence tomography-measured retinal thickness in diabetic macular edema.
ABSTRACT Purpose. To investigate 24-hour variation in retinal thickness in patients with diabetic macular edema (DME) using optical coherence tomography (OCT). Methods. Fifty-three eyes of 53 diabetic patients with clinically significant macular edema and central subfield thickness (CST) >225 µm, 36 eyes of 36 healthy individuals (normal controls), and 22 eyes of 22 diabetic patients without macular pathology (diabetic controls) underwent 5 OCT measurements at 7 am, 10 am, 3 pm, 8 pm, and 1 am. Visual acuity, blood pressure, blood glucose, and body temperature were measured as well. Results. The CST (p<0.0005), total macular volume (p<0.0005), and visual acuity (p<0.0005) showed significant variation in patients. The CST (450 µm at 7 am) reached a minimum at 3 pm (absolute change of -49 µm, relative change of -17%) before increasing again. Thickening changes were higher in more thickened retinas (p<0.0005, p=0.024, absolute and relative change, respectively). Visual acuity was worse in the morning (0.38 logMAR) and improved to a maximum at 8 pm (0.30 logMAR) (p<0.0005). Blood pressure, blood glucose, and body temperature did not vary over time. Conclusions. The 24-hour variation of retinal thickness is observed in a large proportion of patients with DME, with a decrease from morning to afternoon. Time of examination should be taken into account when managing such patients.
- SourceAvailable from: Marion Munk[Show abstract] [Hide abstract]
ABSTRACT: Abstract Aim: To identify influence of orthostasis and daytime on retinal-thickness in cystoid-macular-edema (CME) using SD-OCT. Methods: In this cross-sectional study 18 eyes with uveitis-associated CME (uvCME) were included. Orthostatic-changes of retinal-thickness were analyzed using a Cirrus™ SD-OCT. Retinal-thickness was measured with patients lying horizontally on their side, followed by a fast sitting-up and OCT-measurement in sitting-position. Diurnal-change in thicknesses were assessed by Spectralis™ OCT between 8 AM and 8 PM. Results: Approximately 20 s elapsed between position-change and the following OCT-measurement. In horizontal-position, the mean central retinal thickness (CRT) was 496 ± 37 µm, in upright position, the mean CRT was reduced to 412 ± 43 µm (p = 0.032), thus position-change led to a 17% decrease in CRT. None of the other ETDRS-subfields showed a statistically significant decrease in thicknesses (p > 0.05). In the second experiment, diurnal-CRT decreased over time, whereas the main decrease happened in the morning (8 a.m. 559 ± 35 µm, 12 p.m. 533 ± 36 µm, 4 p.m. 538 ± 32 µm, 8 p.m.551 ± 38 µm, p = 0.01). Thicknesses in all other ETDRS-subgrids did not decrease statistically significantly. Conclusions: Intraretinal-fluid in uvCME may show a high mobility: CRT decreases within seconds after a patient changes position, indicating that position effects retinal-thickness. Main diurnal-decrease in CRT occurs before noon, which is likely due to a position-change in the morning. Patient-population (walk-in patients versus hospitalized, lying patients) and previous waiting-position should be considered when interpreting retinal-thickness in clinical-practice.Current eye research 11/2013; · 1.51 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Optical coherence tomography (OCT) has become an integral tool in the imaging of numerous diseases of the posterior segment. The diagnostic investigation of infectious and noninfectious uveitic conditions often requires multiple imaging modalities in the appropriate clinical context. Modern OCT technology has proved useful not only in the diagnostic investigation of these conditions, but also in monitoring of their clinical course and therapeutic response. Inflammation-induced changes at the level of the retina, retinal pigment epithelium, and choroid can now easily be identified in these conditions using OCT. Prognostic information on visual acuity outcome can also be estimated based on OCT findings. Numerous OCT findings have been described in the setting of the various uveitides. Although none of these findings appear to be pathognomonic for diagnosis of specific uveitic syndromes, in the appropriate clinical context they can add a great deal of information in the diagnosis and management of uveitis.Canadian Journal of Ophthalmology 02/2014; 49(1):18-29. · 1.30 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The literature survey 2012 is based on 1426 papers found in the databases MEDLINE and EMBASE with the keywords “thermography” or “thermometry” “temperature measurement” or “thermotherapy” or ‘skin temperature’ or ‘core temperature’ and restricted to “human” and “included in the databases between 01.01 and 31.12. 2012”. 37.9 percent of papers of this review are originated from Europe and 95.3 percent of all papers are written in English. 238 controlled studies using some kind of temperature measurement were included in this survey. Pharmacology, Internal Medicine, Cancer andNeurology&Psychiatry were the predominant fields of applications of temperature measurement in medicine. As in previous years, therapeutic hypothermia and hyperthermia treatment was the topic of many papers. Fever attracted also a high number of publications. Although the term “breast” appeared in 77 publications, only minority of those were related to breast thermography. Some articles were found for the complex regional pain syndrome and Raynaud´s phenomenon and new applications of medical thermography have been reported.Thermology International 01/2013; 23(3):93-141.