Comparison of Time-Domain OCT and Fundus Photographic Assessments of Retinal Thickening in eyes with Diabetic Macular Edema
Matthew D. Davis 1,
Susan B. Bressler 2,
Lloyd Paul Aiello 3,
Neil Bressler 4,
David J Browning 5,
Christina J. Flaxel 6,
Donald S. Fong 7,
William J Foster 8,
Adam R Glassman 9*,
M. Elizabeth Hartnett 10,
Craig Kollman 11,
Helen Li 12,
Haijing Qin 13,
and
Ingrid U. Scott 14
1 Ophthalmology, Fundus Photograph Reading Center, Madison, Wisconsin, United States
2 Ophthalmology, Wilmer Ophthalmological Institute at Johns Hopkins, Baltimore, Maryland, United States
3 Department of Ophthalmology, Joslin Diabetes Ctr/Harvard Med School, Boston, Massachusetts, United States
4 Ophthalmology, Wilmer Eye Institute, Baltimore, Maryland, United States
5 Ophthalmology, Charlotte Eye Ear Nose and Throat Assoc, PA, Charlotte, North Carolina, United States
6 Ophthalmology, Oregon Health & Science University, Portland, Oregon, United States
7 Ophthalmology, Kaiser Permanente, Pasadena, California, United States
8 Ophthalmology, Charles A. Garcia, P.A and Associates, Houston, Texas, United States
9 DRCR.NET, Jaeb Center for Health Research, 15310 Amberly Drive, Tampa, Florida, 33647, United States
10 Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, United States
11 DRCR.NET, Jaeb Institute, Tampa, Florida, United States
12 Ophthalmology, UTMB, Galveston, Texas, United States
13 DRCR.NET, Diabetic Retinopathy Clinical Research Network, Tampa, Florida, United States
14 Ophthalmology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, United States
* To whom correspondence should be addressed. E-mail: drcrnetX3{at}jaeb.org.
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Abstract |
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Abstract
Purpose: To explore the correlation between optical coherence tomography (OCT) and stereoscopic fundus photographs (FP) for the assessment of retinal thickening (RT) in diabetic macular edema (DME) within a clinical trial.
Methods: OCT, FP and best-corrected visual acuity (VA) measurements were obtained in both eyes of 263 participants in a trial comparing two photocoagulation techniques for DME. Correlation coefficients (r) were calculated comparing RT measured by OCT, RT estimated from FP, and VA. Principal variables were centraler subfield retinal thickness (CSRT) obtained from the OCT fast macular map and DME severity assessed by a reading center using a 7-step photographic scale combining area of thickened retina within 1 disc diameter of the foveal center and thickening at the center.
Results: Medians (quartiles) for retinal thickness within the center subfield by OCT at baseline increased from 236 (214, 264) microns in the lowest level of the photographic scale to 517 (455, 598) microns in the highest level (r=0.67). However, CSRT interquartile ranges were broad and overlapping between FP scale levels and there were many outliers. Correlations between either modality and VA were weaker (r=0.57 for CSRT, and r=0.47 for the FP scale). OCT appeared to be more reproducible and more sensitive to change in RT between baseline and 1 year than was FP.
Conclusion: There was moderate correlation between OCT and FP assessments of RT in patients with DME and slightly less correlation of either measure with VA. OCT and FP provide complementary information but neither is a reliable surrogate for VA.
Key Words:
diabetic retinopathy, macular edema, visual acuity
