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Y. Ouyang, P. Keane, S. Sadda, A. Walsh; Detection of Cystoid Macular Edema With 3D-OCT Versus Fluorescein Angiography. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3283.
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© ARVO (1962-2015); The Authors (2016-present)
Previous studies have demonstrated that dense 3D-OCT macular scans provide higher sensitivity compared to time domain OCT for the detection of clinically relevant features such as cystoid macular edema (CME). The purpose of this study is to compare the sensitivities of 3D-OCT and fluorescein angiography (FA) for the detection of CME and to determine the frequency of FA(-) OCT(+) CME and OCT(-) FA(+) CME in a retinal clinic population.
Retrospective review of randomly selected patients in a retina clinic who underwent digital fluorescein angiography (Topcon 50IX, Topcon Corporation) and 3D-OCT imaging (3D-OCT-1000, Topcon Corporation) on the same day. Two graders evaluated each set of images independently. CME was assessed as present, questionable, or absent based on either late petaloid or honeycomb leakage on FA and/or hyporeflective, intraretinal, cystoid spaces on 3D-OCT (512 Ascans x 128 Bscans).
189 eyes of 98 patients were included in this study. If questionable grades were excluded, a total of 61/189 (32%) eyes had CME either by FA or 3D-OCT. Compared to the combined gold standard of FA+OCT, FA had a sensitivity of 66% (40/61 eyes) for CME detection while 3D-OCT had a sensitivity of 97% (59/61 eyes). The rate of FA(-) OCT(+) CME was 34% (21/61 eyes) while the rate of OCT(-) FA(+) CME was 3% (2/61 eyes). If questionable grades were included as positive, a total of 83/189 (44%) eyes had CME either by FA (58/83, 70%) or 3D-OCT (75/83, 90%) and the rate of FA(-) OCT(+) CME decreased to 30% (25/83 eyes) while the rate of OCT(-) FA(+) CME increased to 10% (8/83 eyes).
3D-OCT appears to be more sensitive than FA for the detection of CME in this retina clinic population. However, there are still cases of angiographic CME that are not detected by 3D-OCT.
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