Macular thickness in diabetic retinopathy without clinically significant macular edema

Aim: To measure macular thickness by optical coherence tomography (OCT) in various grades of diabetic retinopathy with no clinically significant macular edema (CSME) and its comparison with non-diabetics. Design: Prospective cross–sectional study. Methods: Macular thickness was measured by OCT in 72 healthy volunteers (107 control eyes), 45 patients with mild and moderate non-proliferative diabetic retinopathy (NPDR) (78 eyes) and 37 patients with severe NPDR and proliferative diabetic retinopathy (PDR) (66 eyes). Patients with diabetic macular edema (DME) as assessed by stereoscopic evaluation or photographs were excluded. One-way ANOVA test to compare the mean thickness and Tukey's test for multiple comparison between groups were used. Results: Central subfield thickness (CST) was 238.57 ± 25.077 µm, 251.22 ± 24.649 µm, and 270.45 ± 28.956 µm in the three groups respectively. As the severity of retinopathy increased, the macular thickness significantly increased (p = < 0.001) in all the nine zones on OCT. There was a significant increase in CST noted in all the grades of retinopathy when compared with non-diabetics (p = 0.004, p = < 0.0001). No significant difference in macular thickness was noted between genders, irrespective of their groups (p = 0.72), or between the three groups in all the nine zones (p = 0.609). Conclusion: There is a significant increase in CST in all grades of retinopathy, as well as with increasing severity of retinopathy when compared to non-diabetics. This warrants the need to obtain OCT measurements even in patients with moderate NPDR without CSME to rule out subclinical DME.