title: Association between macular perfusion and photoreceptor layer status in diabetic macular edema.
abstract: OBJECTIVE
  To evaluate the relationship between the photoreceptor layer status (inner segment ellipsoid band and external limiting membrane) and the foveal avascular zone size, as a result of macular perfusion, in patients with diabetic macular edema.
  
  
  METHODS
  This observational case series study included 151 eyes of 118 patients with naive diabetic macular edema. The length of the disrupted photoreceptor layer was assessed by optical coherence tomography. The foveal avascular zone diameter was measured on fluorescein angiogram.
  
  
  RESULTS
  No significant association was found between the foveal avascular zone size and the mean lengths of the disrupted inner segment ellipsoid band nor the external limiting membrane in patients with naive diabetic macular edema.
  
  
  CONCLUSIONS
  Macular ischemia, which lengthens the distance from the perifoveal vessels to the center of the fovea and may disrupt the normal flow of nutrients by simple diffusion to the photoreceptor line, does not seem to influence on inner segment ellipsoid band nor external limiting membrane integrity. Future studies may evaluate the effect of choroidal vascularization on the photoreceptor layer status to enhance the knowledge about the photoreceptor layer nutrients source.
authors.affiliation: *Department of Ophthalmology, University Hospital Principe de Asturias, Alcalá de Henares (Madrid), Spain; and †Department of Surgery, Medical and Social Sciences, Faculty of Medicine, Alcalá University, Alcalá de Henares (Madrid), Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Benitez-Herreros
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lopez-Guajardo
authors.forename: Cristina
authors.initials: C
authors.lastname: Camara-Gonzalez
authors.forename: Miguel
authors.initials: M
authors.lastname: Vazquez-Blanco
authors.forename: María
authors.initials: M
authors.lastname: Castro-Rebollo
mesh_terms: D001813:Blood-Retinal Barrier / Q000502:physiology; D002199:Capillary Permeability; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005451:Fluorescein Angiography; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000503:physiopathology; D008269:Macular Edema / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology*; D012171:Retinal Vessels / Q000502:physiology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human