Abstract Background: Diabetic Macular Ischemia (DMI) is recog-nized as an important cause of visual disability, it is considered as an important clinical feature of Diabetic Retinopathy (DR). Disorganization of Retinal Inner Layer (DRIL) is defined as the horizontal extent in microns for which any boundaries between the ganglion cell-inner plexiform layer complex, inner nuclear layer, and outer plexiform layer could not be identified.and considerd as featurer of capillary non perfusion. Aim of Study: To study the rule of dril assessed by Optical Coherence Tomography (OCT) in differentiation between the ischemic and non-ischemic diabetic maculopathy. Patients and Methods: 66 eyes of 66 patients were enrolled in prospective study and divided into 3 equal subgroups; control normal patients, patients with ischemic diabetic maculopathy and patients with non-ischemic diabetic macu-lopathy diagnosed by FFA. All patients underwent full oph-thalmological examination and OCT macula was done to assess the DRIL. Results: We found that there was highly statistically significant difference (p=0.000) between non ischemic and ischemic groups as regard presence or absence of DRIL. Sensitivity of DRIL (by OCT) is 86.36%, specificity is 81.82%, positive predictive value is 82.61% and negative predictive value is 85.71%. Conclusion: There was a statistically significant difference in presence or absence of DRIL between ischemic and non-ischemic diabetic retinopathy.