EXTREME DIURNAL VARIATION OF CENTRAL MACULAR THICKNESS IN DIABETIC MACULAR EDEMA.
OBJECTIVE
Spectral domain optical coherence tomography is an established modality to quantify diabetic macular edema (DME). Change in central subfield thickness exceeding 3% to 6% in DME is likely to be significant. In this case of DME, we describe an extreme bilateral variation in central macular thickness on spectral domain optical coherence tomography over two consecutive days without any treatment.


METHODS
The patient with DME and nonproliferative diabetic retinopathy underwent visual acuity testing, slit-lamp biomicroscopy, and dilated fundus examination. The patient also underwent spectral domain optical coherence tomography and digital fluorescence angiography. Findings are described in case report.


RESULTS
There was an overnight decrease of central subfield thickness from 360 microns to 291 microns (69 [∼19%] microns) in the right eye and from 404 microns to 293 microns (111 [∼27%] microns) in the left eye.


CONCLUSIONS
Extreme fluctuations in retinal thickness in central involving DME are unusual, and the exact mechanism of this fluctuation is poorly understood.
Department of Ophthalmology, University of Florida College of Medicine, Jacksonville, Florida.
Kumar
K
Sambhav
Sandeep
S
Grover
Kakarla V
KV
Chalam
D002940:Circadian Rhythm; D003930:Diabetic Retinopathy / Q000150:complications* / Q000175:diagnosis; D018450:Disease Progression; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005654:Fundus Oculi; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008269:Macular Edema / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D000072776:Slit Lamp Microscopy; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity