PURPOSE To classify the types of diabetic macular edema (DME) and evaluate its morphological features on spectral domain optical coherence tomography (SD-OCT) and determine correlations between visual acuity and OCT findings. METHODS We assessed 406 eyes of 309 patients with a diagnosis of DME retrospectively. Three types based on SD-OCT were identified: diffuse macular edema, cystoid macular edema, and cystoid degeneration. Morphological features such as serous macular detachment (SMD), vitreomacular interface abnormalities (VMAI), hard exudates, photoreceptor status, and correlations between visual acuity and those morphological features were also evaluated by SD-OCT. RESULTS The most common type of DME was cystoid edema (68.5%). No statistically significant difference was found between groups in sex (P = 0.40), type of diabetes (P = 0.50), or diabetic retinopathy (P = 0.78). However, the duration of symptoms and BCVA was significantly lower in the group with cystoid degeneration compared with the group with cystoid edema (P < 0.001) and the group with diffuse macular edema (P < 0.001). In the group with cystoid degeneration compared with the groups with cystoid and diffuse edema, the central fovea and central subfield were significantly thicker (both (P < 0.001), the subfoveal choroid was significantly thinner (P = 0.049), rate of serous macular detachment was significantly lower (P < 0.001), and the rate of outer retinal damage was significantly higher (P < 0.001). CONCLUSIONS Cystoid macular degeneration, which is consistent with poor functional and morphological outcomes, should be differentiated from cystoid macular edema. Serous macular detachment, which is mostly seen in eyes with early stages of DME, should be evaluated as an accompanying morphological finding rather than a type of DME.

中文翻译：

---

糖尿病黄斑水肿的光谱域光学相干断层扫描分类：临床实践的新建议。

目的 对糖尿病黄斑水肿 (DME) 的类型进行分类，并在光谱域光学相干断层扫描 (SD-OCT) 上评估其形态特征，并确定视力和 OCT 结果之间的相关性。方法 我们回顾性评估了 309 名诊断为 DME 的患者的 406 只眼。根据 SD-OCT 确定了三种类型：弥漫性黄斑水肿、黄斑囊样水肿和囊样变性。SD-OCT 还评估了诸如浆液性黄斑脱离 (SMD)、玻璃体黄斑界面异常 (VMAI)、硬性渗出物、光感受器状态以及视力与这些形态特征之间的相关性等形态学特征。结果 最常见的 DME 类型是囊样水肿 (68.5%)。在性别（P = 0.40）、糖尿病类型（P = 0.50）、或糖尿病视网膜病变（P = 0.78）。然而，与囊样水肿组（P < 0.001）和弥漫性黄斑水肿组（P < 0.001）相比，囊样变性组的症状持续时间和BCVA显着降低。囊样变性组与囊样弥漫性水肿组相比，中央凹和中央亚区显着增厚（均P < 0.001），中央凹下脉络膜显着变薄（P = 0.049），浆液性黄斑脱离率显着降低（P < 0.001），外层视网膜损伤率显着升高（P < 0.001）。结论 黄斑囊样变性与功能和形态学结果较差一致，应与黄斑囊样水肿相鉴别。分离，