Background: Diabetic macular edema (DME) is a sightthreatening consequence of diabetic retinopathy. So, identifying
reliable methods for DME prognosis is actually very helpful. Multimodal retinal imaging tools provide us with these predictive prognostic biomarkers Aim of the Work: To correlate between visual functions (visual acuity and color vision) with macular features of OCT, FAF and FFA in patients with untreated (treatment naive) DME as a guide for visual
prognosis of these patients. Patients and Methods: Fifty eyes of35 diabetic patients with untreated clinically significant macular edema (CSME)underwent best corrected visual acuity (BCVA) determination (logMAR), fluoresce in angiography(FFA;FAZ size, macular leakage pattern, areas of capillary dropout)optical coherence tomography (OCT; central point foveal thickness [CPFT], volume, outer and inner retinal layers integrity[ONL,INL],hyper-reflective foci[HRF], subfoveal choroidal thickness[SFCT]); fundus auto fluorescence (Hyper FAF; absent or increased (FAF, single or multiple spots). Linear correlation and three-way analysis of covariance were used for statistics. Results: In OCT, we found that CPFT & ORL integrity is significantly well correlated to visual function (BCVA, color vision).However, CSFT was only correlated to visual acuity but not color vision. Regarding FFA parameters, especially (FAZ size, areas of capillary drop out), we found that these parameters are correlated significantly to visual acuity but not color vision. On the other hand,
we found that the presence of hyper FAF spots was not related significantly to visual acuity but related to a significant level to color vision. However, a number of spots were not correlated to visual acuity or color vision. There was significant correlation between retinal thickness in OCT and type of leakage in FFA. Also, large cystoid spaces and FAF spots in the fovea were significantly correlated together. Conclusions: Integration between different retinal imaging tools in DME helps to find alternative and less invasive way in diagnosis.FAF is new, simple non-invasive imaging mode to assess RPE function with evolving application in DME.