Abstract
Purpose: :
To compare the presence of vitreoretinal interface abnormalities with reference to epiretinal membrane (ERM) in stereoscopic color fundus photographs and optical coherence tomograms (OCT).
Methods: :
Color photographs were evaluated independently by trained ocular disease evaluators (ODEs) for presence and traction due to ERM according to Early Treatment of Diabetic Retinopathy Study grading procedures (ETDRS Report no. 10). OCTs were evaluated independently by trained ODEs for the same variables. An ERM was evaluated as definitely present if a well delineated hyperreflective band with bridging tissue was visible inner to and in close proximity to the internal limiting membrane. An ERM was graded as questionable if there was corrugation in the innermost retinal layers in the absence of a well delineated hyperreflective band. Retinal traction was identified in eyes with definite ERM if the retinal surface had tenting or scalloping at the point(s) of attachment.Data from corresponding color photographs and OCT images evaluated from multiple multicenter clinical trials in diabetes was analyzed.
Results: :
Data from 2046 eyes with corresponding OCT and color photograph visits was analyzed. 118 were excluded due to one or both images being ungradable. ERM was present on 256 (13.3%) color photographs. Severity of ERM was categorized as cellophane reflex in 14 (5.5%), subtle membranes in 39 (15.2%), and obvious membranes in 203 (79.3%). ERM was present on 545 (28.3%) OCTs, with 190 (34.9%) located outside the central subfield and 355 (65.1%) involving the central subfield. ERM was present on both color photographs and OCT in 180 (9.4%) pairs. 357 (18.5%) pairs had ERMs on OCT but not on the color photograph and 56 (2.9%) pairs had ERMs present on the color photograph but not on OCT. Of the ERMs visible only on color photographs, most were of the cellophane reflex type. Retinal traction was identified in 10 (5.6%) eyes on either color photographs or OCT.
Conclusions: :
OCT is more sensitive to detecting ERMs than color photographs. Subtle ERM denoted as cellophane reflex may be detected more sensitively by color photographs than OCT.
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • imaging/image analysis: clinical • retina