Abstract
Abstract: :
Purpose: To compare optical coherence tomography (OCT) with fundus fluorescein angiography (FA) in detecting pseudophakic cystoid macular edema (CME). Methods: 36 eyes with clinically suspected pseudophakic CME underwent FA and OCT (Zeiss–Humphrey, Model 3000, Dublin, CA) at the initial visit. Eyes with diabetic retinopathy or other macular diseases were excluded. Eyes with mild epiretinal membranes were included if the macula was not involved. A grading scale between Grade A (Normal macula) and Grade E (Severe edema with subretinal fluid) was devised for OCT images. Likewise, a grading scale between 0 (No hyperfluorescence) to Grade 4 (Severe hyperfluorescence, equal to or greater than 1.5 disc diameter) was devised for FA. The rate of abnormality detected on OCT was compared with FA. Additional parameters such as foveal thickness measured on OCT and inter– and intra–grader reliability were examined. Results: Of 36 eyes with clinically suspected CME, 34 had FA confirmed CME and 33 had positive OCT findings. Of 34 eyes with FA–confirmed CME, OCT was positive in 31 eyes (91%). In 25 eyes with mild CME, defined as FA grade 1 or 2, OCT was positive in 22 eyes (88%). In 9 eyes with moderate or severe CME (FA grade 3 or 4), OCT was positive in 9 eyes (100%). In 2 eyes, OCT was positive although FA was normal. Agreement between FA and OCT was observed in 31/36 eyes (86%). Of the 5 eyes (14%) without agreement, 3 eyes had mild FA–confirmed CME and normal OCT, and 2 eyes had normal FA and positive OCT of mild degree. Average retinal thickness measured on 1mm circle on topography map of OCT for our subjects was 212 +/– 34um for Stage A, 314+/– 84um for Stage B, 321 +/– 77 um for Stage C, and 542 +/– 68um for Stage D. Inter–reliability of the grading protocol for both FA and OCT was measured at 93.2% and intra–reliability was 94.1%. Conclusions:In eyes with clinically suspected pseudophakic CME, FA and OCT correlated in 86%. OCT appeared as sensitive as FA in detecting moderate to severe CME, and detected mild grades of retinal abnormality not shown by FA. It had a lower rate of sensitivity in eyes with mild FA leakage. OCT may be a useful adjunct to FA and can be considered in patients who cannot unergo FA as a means of detecting pseudophakic CME.
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • imaging/image analysis: clinical • macula/fovea