Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema: An Attempt of Composite Grading of Macular Edema

Stela Vujosevic; Monica Varano; Catherine Egan; Sobha Sivaprasad; Geeta Menon; Ali Erginay; Frank D Verbraak; Henrik Lund-Andersen; Jose P Martinez; Ignasi Jürgens; Erica Smets; Caroline Coriat; Peter Wiedemann; Victor Ágoas; Giuseppe Querques; Frank G Holz; Sandrina Nunes; Dalila Alves; Catarina Neves; Torcato Santos; Luisa Ribeiro; Francesco Bandello; Amparo Navea Tejerina; José Cunha-Vaz

doi:10.1159/000441110

Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema: An Attempt of Composite Grading of Macular Edema

Stela Vujosevic, Monica Varano, Catherine Egan, Sobha Sivaprasad, Geeta Menon, Ali Erginay, Frank D Verbraak, Henrik Lund-Andersen, Jose P Martinez, Ignasi Jürgens, Erica Smets, Caroline Coriat, Peter Wiedemann, Victor Ágoas, Giuseppe Querques, Frank G Holz, Sandrina Nunes, Dalila Alves, Catarina Neves, Torcato SantosLuisa Ribeiro, Francesco Bandello, Amparo Navea Tejerina, José Cunha-Vaz,

Medical retina and Uveitis

Research output: Contribution to journal › Article › Research › peer-review

Abstract

PURPOSE: To characterize the relevance of macular thickness changes in the inner and outer rings in the progression of macular edema in eyes/patients with diabetes type 2.

METHODS: A total of 374 type 2 diabetic patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20-35) were included in a 12-month prospective observational study to identify retinopathy progression. Retinal thickness analyses were performed in 194 eyes/patients using Cirrus SD- OCT and 166 eyes/patients using Spectralis SD-OCT. The DRCR.net classification of subclinical and clinical macular edema was used. A composite grading of macular edema is proposed in this study.

RESULTS: A total of 317 eyes/patients completed the study. SD-OCT identified clinical macular edema in 24 eyes/patients (6.7%) and subclinical macular edema in 104 eyes/patients (28.9%) at baseline. Increased thickness of the central subfield is the best predictor for the development of clinical macular edema, with 85.7% sensitivity and 71.9% specificity (OR: 2.57, 95% CI: 0.82-7.99). However, the involvement of the inner and outer rings is a cumulative predictor of progression to clinical macular edema (OR: 8.69, 95% CI: 2.85-26.52).

CONCLUSIONS: A composite OCT grading of macular edema taking into account the retinal thickness changes in the inner and outer macular rings offers a simple way to characterize macular edema, with added clinical value.

Original language	English
Pages (from-to)	19-25
Number of pages	7
Journal	Ophthalmic Research
Volume	55
Issue number	1
DOIs	https://doi.org/10.1159/000441110
Publication status	Published - 2015

Keywords

Adult
Aged
Aged, 80 and over
Diabetes Mellitus, Type 2/complications
Diabetic Retinopathy/classification
Disease Progression
Female
Follow-Up Studies
Humans
Macular Edema/classification
Male
Middle Aged
Organ Size
Prospective Studies
Retina/pathology
Sensitivity and Specificity
Tomography, Optical Coherence
Visual Acuity/physiology

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10.1159/000441110

Cite this

Vujosevic, S., Varano, M., Egan, C., Sivaprasad, S., Menon, G., Erginay, A., Verbraak, F. D., Lund-Andersen, H., Martinez, J. P., Jürgens, I., Smets, E., Coriat, C., Wiedemann, P., Ágoas, V., Querques, G., Holz, F. G., Nunes, S., Alves, D., Neves, C. (2015). Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema: An Attempt of Composite Grading of Macular Edema. Ophthalmic Research, 55(1), 19-25. https://doi.org/10.1159/000441110

@article{b7a9529becfb4364b3f727dc5943e976,

title = "Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema: An Attempt of Composite Grading of Macular Edema",

abstract = "PURPOSE: To characterize the relevance of macular thickness changes in the inner and outer rings in the progression of macular edema in eyes/patients with diabetes type 2.METHODS: A total of 374 type 2 diabetic patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20-35) were included in a 12-month prospective observational study to identify retinopathy progression. Retinal thickness analyses were performed in 194 eyes/patients using Cirrus SD- OCT and 166 eyes/patients using Spectralis SD-OCT. The DRCR.net classification of subclinical and clinical macular edema was used. A composite grading of macular edema is proposed in this study.RESULTS: A total of 317 eyes/patients completed the study. SD-OCT identified clinical macular edema in 24 eyes/patients (6.7%) and subclinical macular edema in 104 eyes/patients (28.9%) at baseline. Increased thickness of the central subfield is the best predictor for the development of clinical macular edema, with 85.7% sensitivity and 71.9% specificity (OR: 2.57, 95% CI: 0.82-7.99). However, the involvement of the inner and outer rings is a cumulative predictor of progression to clinical macular edema (OR: 8.69, 95% CI: 2.85-26.52).CONCLUSIONS: A composite OCT grading of macular edema taking into account the retinal thickness changes in the inner and outer macular rings offers a simple way to characterize macular edema, with added clinical value.",

keywords = "Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Type 2/complications, Diabetic Retinopathy/classification, Disease Progression, Female, Follow-Up Studies, Humans, Macular Edema/classification, Male, Middle Aged, Organ Size, Prospective Studies, Retina/pathology, Sensitivity and Specificity, Tomography, Optical Coherence, Visual Acuity/physiology",

author = "Stela Vujosevic and Monica Varano and Catherine Egan and Sobha Sivaprasad and Geeta Menon and Ali Erginay and Verbraak, {Frank D} and Henrik Lund-Andersen and Martinez, {Jose P} and Ignasi J{\"u}rgens and Erica Smets and Caroline Coriat and Peter Wiedemann and Victor {\'A}goas and Giuseppe Querques and Holz, {Frank G} and Sandrina Nunes and Dalila Alves and Catarina Neves and Torcato Santos and Luisa Ribeiro and Francesco Bandello and Tejerina, {Amparo Navea} and Jos{\'e} Cunha-Vaz",

note = "{\textcopyright} 2015 S. Karger AG, Basel.",

year = "2015",

doi = "10.1159/000441110",

language = "English",

volume = "55",

pages = "19--25",

number = "1",

}

Vujosevic, S, Varano, M, Egan, C, Sivaprasad, S, Menon, G, Erginay, A, Verbraak, FD, Lund-Andersen, H, Martinez, JP, Jürgens, I, Smets, E, Coriat, C, Wiedemann, P, Ágoas, V, Querques, G, Holz, FG, Nunes, S, Alves, D, Neves, C, Santos, T, Ribeiro, L, Bandello, F, Tejerina, AN, Cunha-Vaz, J 2015, 'Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema: An Attempt of Composite Grading of Macular Edema', Ophthalmic Research, vol. 55, no. 1, pp. 19-25. https://doi.org/10.1159/000441110

TY - JOUR

T1 - Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema

T2 - An Attempt of Composite Grading of Macular Edema

AU - Vujosevic, Stela

AU - Varano, Monica

AU - Egan, Catherine

AU - Sivaprasad, Sobha

AU - Menon, Geeta

AU - Erginay, Ali

AU - Verbraak, Frank D

AU - Lund-Andersen, Henrik

AU - Martinez, Jose P

AU - Jürgens, Ignasi

AU - Smets, Erica

AU - Coriat, Caroline

AU - Wiedemann, Peter

AU - Ágoas, Victor

AU - Querques, Giuseppe

AU - Holz, Frank G

AU - Nunes, Sandrina

AU - Alves, Dalila

AU - Neves, Catarina

AU - Santos, Torcato

AU - Ribeiro, Luisa

AU - Bandello, Francesco

AU - Tejerina, Amparo Navea

AU - Cunha-Vaz, José

PY - 2015

Y1 - 2015

N2 - PURPOSE: To characterize the relevance of macular thickness changes in the inner and outer rings in the progression of macular edema in eyes/patients with diabetes type 2.METHODS: A total of 374 type 2 diabetic patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20-35) were included in a 12-month prospective observational study to identify retinopathy progression. Retinal thickness analyses were performed in 194 eyes/patients using Cirrus SD- OCT and 166 eyes/patients using Spectralis SD-OCT. The DRCR.net classification of subclinical and clinical macular edema was used. A composite grading of macular edema is proposed in this study.RESULTS: A total of 317 eyes/patients completed the study. SD-OCT identified clinical macular edema in 24 eyes/patients (6.7%) and subclinical macular edema in 104 eyes/patients (28.9%) at baseline. Increased thickness of the central subfield is the best predictor for the development of clinical macular edema, with 85.7% sensitivity and 71.9% specificity (OR: 2.57, 95% CI: 0.82-7.99). However, the involvement of the inner and outer rings is a cumulative predictor of progression to clinical macular edema (OR: 8.69, 95% CI: 2.85-26.52).CONCLUSIONS: A composite OCT grading of macular edema taking into account the retinal thickness changes in the inner and outer macular rings offers a simple way to characterize macular edema, with added clinical value.

AB - PURPOSE: To characterize the relevance of macular thickness changes in the inner and outer rings in the progression of macular edema in eyes/patients with diabetes type 2.METHODS: A total of 374 type 2 diabetic patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20-35) were included in a 12-month prospective observational study to identify retinopathy progression. Retinal thickness analyses were performed in 194 eyes/patients using Cirrus SD- OCT and 166 eyes/patients using Spectralis SD-OCT. The DRCR.net classification of subclinical and clinical macular edema was used. A composite grading of macular edema is proposed in this study.RESULTS: A total of 317 eyes/patients completed the study. SD-OCT identified clinical macular edema in 24 eyes/patients (6.7%) and subclinical macular edema in 104 eyes/patients (28.9%) at baseline. Increased thickness of the central subfield is the best predictor for the development of clinical macular edema, with 85.7% sensitivity and 71.9% specificity (OR: 2.57, 95% CI: 0.82-7.99). However, the involvement of the inner and outer rings is a cumulative predictor of progression to clinical macular edema (OR: 8.69, 95% CI: 2.85-26.52).CONCLUSIONS: A composite OCT grading of macular edema taking into account the retinal thickness changes in the inner and outer macular rings offers a simple way to characterize macular edema, with added clinical value.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Diabetes Mellitus, Type 2/complications

KW - Diabetic Retinopathy/classification

KW - Disease Progression

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Macular Edema/classification

KW - Male

KW - Middle Aged

KW - Organ Size

KW - Prospective Studies

KW - Retina/pathology

KW - Sensitivity and Specificity

KW - Tomography, Optical Coherence

KW - Visual Acuity/physiology

U2 - 10.1159/000441110

DO - 10.1159/000441110

M3 - Article

C2 - 26555067

SN - 0030-3747

VL - 55

SP - 19

EP - 25

JO - Ophthalmic Research

JF - Ophthalmic Research

IS - 1

ER -

Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema: An Attempt of Composite Grading of Macular Edema

Abstract

Keywords

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