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A. R. Batchelet, M. W. Compton, S. S. Allam, N. G. Ghazi; Prognostic Optical Coherence Tomography Factors in Cystoid Macular Edema. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2689.
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© ARVO (1962-2015); The Authors (2016-present)
to evaluate optical coherence tomography (OCT) findings that may be of prognostic value for final visual outcome in patients with cystoid macular edema (CME)
A retrospective chart review of all patients diagnosed with new onset cystoid macular edema that presented to the University of Virginia over a period of two years was performed. All included patients had a Stratus OCT and fluorescein angiography (FA) as part of their initial evaluation. Patients with ischemic maculopathy noted on FA or vitreomacular traction discovered on OCT were excluded. After assessing OCT reliability, each of the six line scans of the fast macular study were analyzed for the following parameters: size, number, and location of cysts with respect to center; extent of retinal involvement; central macular (CMT) and foveal (CFT) thickness; thickness of residual retina above and below the cystic area; involvement of photoreceptors and retinal pigment epithelium layers; the presence of intact retinal processes spanning the retinal thickness; and the presence of subretinal fluid. Included patients were divided into two groups ("no improvement group" and "improvement group") based on visual acuity improvement of at least two Snellen lines between the date of diagnosis and last follow-up regardless of management method. The two groups were compared for each of the above listed OCT factors. For the statistical analysis of continuous variables, the Wilcoxon test was used whereas the chi-squared test was used for non-continuous variables and comparison of proportions.
Seventy seven charts were included in this study; however, at the time of this writing, the data of only 23 has been analyzed (14 in the "no improvement group" and nine in the "improvement group"). The only OCT finding that significantly correlated with visual improvement was the thickness of residual retinal tissue above the central cyst at presentation (p = 0.006). A trend towards visual improvement was noticed in association with some factors although this did not reach statistical significance. These factors included the presence of intact central processes spanning the full retinal thickness (p = 0.07), CFT (p = 0.08), and CMT (p= 0.09).
This analysis suggests that certain OCT characteristics may be of prognostic value in patients with CME. Analysis of the data on the remaining 54 patients will be available for the ARVO meeting and will help elucidate these preliminary findings.
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