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Comparison of Time-Domain OCT and Fundus Photographic Assessments of Retinal Thickening in Eyes with Diabetic Macular Edema

¹From the Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin; the ²Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland; the ³Beetham Eye Institute, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts; ⁴Charlotte Eye, Ear, Nose and Throat Associates, Charlotte, North Carolina; ⁵Casey Eye Institute, Oregon Health and Science University, Portland, Oregon; the ⁶Department of Ophthalmology, Kaiser Permanente Southern California, Baldwin Park, California; the ⁷Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; the ⁸Department of Ophthalmology, Weill Cornell Medical College at The Methodist Hospital, Houston, Texas; the ⁹Department of Physics, The University of Houston, Houston, Texas; the ¹⁰Jaeb Center for Health Research, Tampa, Florida; the ¹¹Department of Ophthalmology, University of North Carolina School of Medicine, Chapel Hill, North Carolina; the ¹²Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch School of Medicine, Galveston, Texas; and the ¹³Department of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.

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 central subfield retinal thickness (CSRT) obtained from the OCT fast macular map and DME severity assessed by a reading center using a seven-step photographic scale combining the 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) µm in the lowest level of the photographic scale to 517 (455, 598) µm 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.

CONCLUSIONS. There was a 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. (ClinicalTrials.gov number, NCT00071773.)

This article has been cited by other articles:

				R. E. Gangnon, M. D. Davis, L. D. Hubbard, L. M. Aiello, E. Y. Chew, F. L. Ferris III, M. R. Fisher, and the Early Treatment Diabetic Retinopathy Study Res A Severity Scale for Diabetic Macular Edema Developed from ETDRS Data Invest. Ophthalmol. Vis. Sci., November 1, 2008; 49(11): 5041 - 5047. [Abstract] [Full Text] [PDF]