Abstract
Purpose: :
To compare the sensitivity for detection and characterization of cystoid macular edema (CME) in various retinal pathologies using the Spectral OCT/SLO (OPKO/OTI, Miami, FL) and FA (Topcon TRC-501X FA, Topcon Medical Systems Inc., Paramus, NJ).
Methods: :
A retrospective review was made of cases with the clinical diagnosis of CME that were imaged with the Spectral OCT/SLO between October 2007 and October 2008. Of these 360 cases, 85 had FA performed on the same day. FA images were reviewed for evidence of leakage consistent with CME. The OCT/SLO images were then evaluated for intraretinal cystic changes characteristic of CME, as well as structural evidence of longstanding CME. Images from the FA and OCT/SLO were superimposed using Adobe PhotoshopTM to compare features and assess their extent of correlation.
Results: :
The most common causes of CME in this study were retinal vein occlusion (BRVO, CRVO) and diabetic retinopathy (DR). Percentage of missed CME diagnosis by FA for DR, AMD and retinal vein occlusion were 33%, 33% and 18.51% respectively. Spectral OCT/SLO allowed earlier diagnosis than FA in a few cases. OCT revealed residual CME with a normal FA in one follow up case. OCT also revealed late complications of long standing CME: secondary macular holes (2 eyes), secondary epimacular membrane (3 eyes), secondary subretinal fluid (5 eyes), retinal pigment epithelium detachment (1 eye) and photoreceptor atrophy (1 eye).
Conclusions: :
Spectral OCT/SLO imaging appears more sensitive than fluorescein angiography (FA) in detecting cystoid macular edema in many cases. It may be particularly valuable for earlier diagnosis, extended follow up and monitoring of late complications.
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • retina