Diabetic macular edema (DME) is defined as presence of retinal thickening more than twice the diameter of a major retinal vein at optic disc margin in the area ½- 1 disk diameter (DD) from macular center in eyes with underlying retinopathy.(1)
It is one of the leading causes of blindness among adults, accounting for approximately 5% of global blindness.(2)
The pathogenesis of DME is complex and multifactorial. It occurs mainly as a result of disruption of the blood-retinal barrier (BRB), which leads to increased intraretinal accumulation of fluid. Sustained hyperglycemia causes release of several vasoactive substances that contribute to further BRB damage. In addition, associated vitreoretinal interface abnormalities may exacerbate macular edema by causing mechanical traction.(3)
Usingdifferent imaging modalities is mandatory for proper management of DME. Fundus photography is essential in screening and documentation of diabetic retinopathy. Fluorescein angiography is helpful in diagnosis of macular edema, retinal ischaemia and vascular abnormalities. Optical coherence tomography (OCT) has become a critical tool in diagnosis and treatment of macular edema especially in the current anti-vascular endothelial growth factor (VEGF) era. Newer modalities such as autofluorescence imaging, OCT-Angiography, and adaptive optics are showing promises to improve current practice.(4)