Fast Five Quiz: Diabetic Macular Edema

Andrew A. Dahl, MD


October 20, 2020

Figure 3. Optical coherence tomography showing normal human fovea of right eye: cross section of foveal pit, retinal layers and choroid.

Slit lamp biomicroscopy using a condensing lens and high magnification provides a well-illuminated stereoscopic technique to diagnose DME. It should be performed on every patient with diabetes to assess for DME.

An indirect ophthalmoscope does not provide adequate magnification for the diagnosis of DME. It does allow for the evaluation for other forms of diabetic retinopathy.

Optical coherence tomography (OCT) captures reflected light from retinal structures to create a cross-sectional image of the retina, like histologic sections as seen with a light microscope. DME can be seen by OCT. However, current practice guidelines do not recommend OCT as the modality to establish a diagnosis of DME. OCT is widely used as an additional tool to evaluate, document, and quantify various macular pathology.

Fluorescein angiography is not used to diagnose DME. It should be performed to distinguish between focal and diffuse leakage, if there is consideration of treating any focal leakage away from the fovea with laser photocoagulation.

Learn more about the workup of DME.


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