Abstract
Purpose: :
To compare the accuracy of macular biomicroscopy (MB) and Fluorescein Angiography (FA) with Optical Coherence Tomography (Stratus OCT) on diagnostic of Macular Edema secondary to Branch Retinal Vein Occlusion (BRVO).
Methods: :
We prospectively studied 21 patients with BRVO ranging from 2 to 24 months of duration, evaluation included MB, FA and OCT. MB was performed by one experienced retinal specialist with a 78D lens in a masked fashion for presence of macular edema, presence of cystoid spaces within the retina and presence of serous macular detachment. FA images were evaluated in a masked fashion by other specialist for cystoid loculation of fluorescein, leakage, staining of vessels and presence of serous macular detachment. OCT evaluated macular thickness map, cystoid spaces within the retina and presence of serous macular detachment, also in a masked fashion.
Results: :
The median age of the 21 patients was 59 years ranging from 34 to 85 years, and the median visual acuity of the eyes examined was 0.49 +0.46 logmar. The median OCT foveal thickness was 356.5 +123 µm. Serous macular detachment was seen by OCT in 8 cases (38.1%), intraretinal cysts in 17 cases (81 %) and macular edema in 20 cases (95.2%). Concordance between MB and OCT was statistically significant for presence of macular edema (Kappa = 0.644, p < 0,001), significant for presence of intraretinal cysts with poor concordance (Kappa = 0.352, p = 0,017) and not statistically significant for detection of Serous Macular Detachment with poor concordance (Kappa=0.310 p=0,077).
Flourescein leakage was seen in 16 cases and staining in 15 cases. Leakage or staining seen shown by FA was not correlated with the OCT finding of serous macular detachment. Leakage shown by FA was correlated with the OCT finding of intraretinal cysts (Fisher’s test 0,028).
Macular thickness map analyze seen by OCT was compared to MB analyze in 9 different areas. In 8 cases (38.1%) MB findings were not correlated with the Macular thickness map seen by OCT, median macular thickness was 349,05 µm +51.3 in the areas with no agreement, superior and nasal were the most mistaken areas.
Conclusions: :
We found high concordance between MB and OCT for detection of macular edema, poor concordance for presence of cysts and poor concordance for detection of serous macular detachment. Leakage shown by FA was correlated with the OCT finding of intraretinal cysts. Poor detection of macular edema seen by MB compared to seen by OCT occurred most commonly on superior and nasal areas with median thickness of 349,05µm.
Keywords: vascular occlusion/vascular occlusive disease • macula/fovea • imaging/image analysis: clinical