Study of Imaging Biomarkers as a Prognostic Factor and Guide in theManagement of Diabetic Macular Oedema at a Tertiary Care Center inWestern Gujarat

Introduction: Diabetic Macular Edema (DME) is a leading cause of visual impairment in diabetic patients andis closely linked to structural changes in the retina detectable via optical coherence tomography (OCT).Identifying imaging biomarkers can aid in predicting visual prognosis and guiding personalized treatmentapproaches.Material and Methods: This prospective observational study was conducted over one year at a tertiary carecenter in Western Gujarat, including 123 patients diagnosed with center-involving DME. Comprehensiveophthalmic evaluation and SD-OCT imaging were performed to assess biomarkers such as intraretinal cysts,hyperreflective foci, disorganization of retinal inner layers (DRIL), and subretinal fluid. Systemic parametersincluding HbA1c and serum cholesterol levels were also recorded and analyzed.Results: The most common biomarker observed was DRIL (27.64%), followed by intraretinal cysts (26.01%)and hyperreflective foci (22.76%). Patients with DRIL and disrupted ELM showed significantly worse BCVA(mean logMAR 1.30). Higher HbA1c levels were associated with intraretinal cysts (mean 8.56%, p=0.014) andVMI abnormalities (mean 8.91%, p=0.042). Hyper reflective foci correlated with higher cholesterol levels(mean 288.36 mg/dL, p=0.011), indicating systemic metabolic influence on retinal pathology.Conclusion: OCT-based imaging biomarkers are predictive of visual outcomes in DME and reflect systemicdisease severity. Integrating retinal imaging with metabolic control can optimize management strategies.