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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

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  • 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
  • EVICR.net
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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
JournalOphthalmic Research
Volume55
Issue number1
Pages (from-to)19-25
Number of pages7
ISSN0030-3747
DOIs
Publication statusPublished - Dec 2015

ID: 45977343