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,

Research output: Contribution to journalArticleResearchpeer-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 languageEnglish
Pages (from-to)19-25
Number of pages7
JournalOphthalmic Research
Volume55
Issue number1
DOIs
Publication statusPublished - 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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