The Study Of Visual Function In Relation To Morphological Changes And Traditional Chinese Medicine Syndrome Types With Diabetic Macular Edema

ObjectivesTo study the best corrected visual acuity(BCVA), microperimetric macular sensitivity and the fixation stability in relation to morphological index obtained by optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) and TCM syndrome type in diabetic macular edema (DME)Method30patients(56eyes) who were diagnosed according to diagnostic criteria of D.ME were randomly chosen to undergo comprehensive eye examination. The edema types and edema area were measured by FFA. The average foveal thickness of lmm diameter and total macular edema volume were measured using OCT. The mean retinal sensitivity of central10degrees and fixation stability were measured using microperimetry. TCM syndrome types were divided into five patterns, including Patterns of Deficient Qi and Yin inducing Dryness and Heat Collecting, Patterns of Deficient Qi and Yin, Patterns of Deficient Spleen and Kidney Qi, Patterns of Congealed blood, and Patterns of Mucus and Congealed Blood Collecting. All the data was analyzed using SPSS17.0statistical software.ResultBCVA showed that29eyes were0.1-0.3,16eyes were16and11eyes were0.6-0.9. The edema types revealed that6eyes were circumscribed macular edema,27eyes were diffuse macular edema and23eyes were cystoid macular edema. Mean retinal sensitivity of central10degrees shows8eyes were<10db,31eyes were10-15db and17eyes were15-20db. Fixation stability revealed that19eyes had stable fixation,22eye had relatively unstable fixation and15eyes had unstable fixation. There are statisticall meanfuling difference in BCVA (P=0.002), mean retinal sensitivity of central10degrees (P=0.018) and fixation stability (P=0.001) of different edema types. BCVA (P=0.192>0.05) and mean retinal sensitivity of central10degrees (P=0.701)0.05) in diffuse macular edema are not statistically different from those in cystoid macular edema. BCVA and mean retinal sensitivity of central10degrees in diffuse macular edema and cystoid macular edema both are statistically different from those in circumscribed macular edema. Fixation stability in circumscribed macular edema is not statistically different from it in diffuse macular edema (P=0.249>0.05). Fixation stability in circumscribed macular edema and diffuse macular edema are both statistically different from it in cystoid macular edema. There are statistical] meanfuling difference in BCVA (P=0.031), mean retinal sensitivity of central10degrees (P=0.000) and fixation stability (P=0.003) of different TCM syndrome types.Conelusion(1)With macular edema volume, edema area and the average foveal thickness of lmm diameter increasing, BCVA and mean retinal sensitivity of central10degrees drop while fixation stability becomes poor.(2)With BCVA and mean retinal sensitivity of central10degrees dropping and fixation stability becoming poor, the edema types develop from circumscribed macular edema towards diffuse macular edema and cystoid macular edema.(3)Once patients were diagnosed with circumscribed macular edema, active intervention and early treatment should be taken to prevent serious damage to BCVA and mean retinal sensitivity of central10degrees.(4)Cystoid macular edema has more suppression to fixation stability than circumscribed macular edema and diffuse macular edema.(5)With BCVA and mean retinal sensitivity of central10degrees dropping and fixation stability becoming poor, TCM syndrome types develop from Patterns of Deficient Qi and Yin towards Patterns of Deficient Spleen and Kidney Qi and Patterns of Mucus and Congealed Blood Collecting.