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S. J. Kim, M.-L. Belair, N. M. Bressler, J. P. Dunn, Jr., J. E. Thorne, S. R. Kedhar, D. A. Jabs; A Standardized Method of Reporting Macular Edema After Cataract Surgery Using Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4153.
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To validate a method of reporting macular edema (ME) after cataract surgery using optical coherence tomography (OCT).
Data were analyzed on 130 eyes with either diabetes, uveitis, or neither condition (healthy controls), who underwent uncomplicated cataract surgery, and were followed prospectively for the incidence of ME using OCT. Each eye underwent OCT testing within 4 weeks before surgery, and at 1-month and 3-month post-operative visits. Best-corrected visual acuity (BCVA) was recorded at each visit. ME was defined as an increase in baseline center point thickness (CPT) on OCT associated with cystic changes and impaired vision.
The incidence of ME on OCT in this study was 14% (95% confidence interval (CI) 8% to 20%). The average increase in baseline CPT at 1 month for eyes with and without ME was 202 ± 113 µm and 8 ± 19 µm, respectively (P < 0.001), which resulted in a small loss of vision (-0.02 logMAR units) and 3 line gain of vision (0.29 logMAR units), respectively (P < 0.001). The percent change in baseline CPT for eyes with and without ME was 115 ± 67 and 6 ± 11, respectively (P < 0.001). Use of a 40% or greater increase in baseline CPT to define ME accurately detected 100% of eyes with ME and 99% of eyes without ME in this study. Alternatively, use of a 242 µm or greater cutoff to define ME accurately detected 94% of eyes with ME and 96% of eyes without ME.
A 40% or greater increase in baseline CPT, determined by OCT, offers a simple, objective, reliable, and valid means of reporting post-cataract ME. Alternatively, use of a minimum cutoff of 242 µm could be used when baseline CPT’s are not available. Standardizing detection and reporting of post-cataract ME would allow for uniform accounting of disease incidence and progression and objective comparisons of therapies.
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