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A. A. Khanifar, S. W. Cousins; Comparison of Optical Coherence Tomography With Heidelberg Retinal Tomography Retinal Thickness Maps in the Detection of Macular Thickening in Diabetic Retinopathy and Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2602.
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Detection of macular edema (ME) in nonproliferative diabetic retinopathy and neovascular age-related macular degeneration (AMD) is crucial for the diagnosis and early referral of eyes prior to the development of severe vision loss. Optical coherence tomography (OCT) can image macular edema in two ways: cross sections performed along each of six specific scan meridians or as a topographical map of retinal thickness in the central 6 mm by estimation using interpolation between the six scans. Because of the interpolation, the surface map may be prone to inaccuracy. The Heidelberg Retinal Tomograph Retina Module (HRT3, Heidelberg Engineering GmbH, Heidelberg, Germany) can also measure ME by a producing a topographical map based on direct measurement of retinal thickness. We sought to compare the ability of OCT thickness map with the HRT thickness map in the detection of macular edema in both diabetic retinopathy and wet AMD.
A retrospective comparison was performed of eyes being evaluated for diabetic macular edema (DME) and AMD at the Duke University Eye Center that underwent both HRT and OCT imaging. Only eyes with moderate non-proliferative diabetic retinopathy or AMD referred to rule out neovascularization without evident hemorrhage or scarring were included. All eyes received fluorescein angiography (FA) and retinal examination by the authors. The accuracy of detection of diabetic macular edema and neovascular AMD (defined by clinical exam and FA) was compared between the OCT topographic map and HRT map.
12 eyes were evaluated for the presence of DME, and 15 for the presence of thickening associated with neovascular AMD. For DME, the HRT map correlated with the clinical diagnosis in 10/12 eyes and the OCT map correlated in 9/12 eyes. The OCT produced false negative result in 3 eyes with clinically significant DME, whereas the HRT produced one false positive and one false negative. For neovascular AMD, both techniques were accurate in 12/15 eyes. The OCT map had no false positives, but 3 false negatives. The HRT map had 2 false positives but only 1 false negative.
Preliminary results from this currently small cohort suggest that both OCT and HRT map functions were reasonably accurate in detecting retinal thickening in DME and neovascular AMD. Preliminary data suggested that HRT may be slightly more sensitive but less specific than OCT. Results from additional subjects will help to clarify these findings.
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