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Daniel Rock, Lydia Marahrens, Raimar Kern, Tjalf Ziemssen, Andreas Fritsche, Focke Ziemssen; Limitations of Retinal Thickness Analysis in Cross-Sectional Data. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4264.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze potential influence factors on changes seen in multilayer intra-retinal segmentation data in a cross-sectional cohort.
The prospective DiabCheckOCTplus® study was a non-interventional study of 810 adults recruited in 3 secondary diabetes care centers during a period of 4 month (NCT02311504). All patients of the investigator initiated study were included after confirmed diagnosis of diabetes and underwent a comprehensive eye examination and macula-centered spectral-domain optical coherence scans (Heidelberg Spectralis). The OCT scans were segmented into separate surfaces, and the average thickness between internal limiting membrane and outer retinal pigment epithelium complex surfaces was determined using the Spectralis algorithm.1,2Clinical data (duration, metabolic control, medication, laboratory values) was provided for the analysis. For continuous outcomes, significant differences were evaluated with the one-way ANOVA (α=0.05). Multivariate logistic regression was performed to determine factors associated with the thickness of individual retinal layers. The statistical analyses were performed with SPSS 22 (IBM).
The images were analyzed for 793 patients with diabetes (right eye: 793, left eye: 792). The correlation coefficient of the comparison between the fellow-eyes was 0.68 (p<0.001). Within the central subfield the mean retinal thickness was 281 µm (95%-CI: 278, 284). After excluding the subgroup with macular edema and vitreomacular interface pathologies,3 the retinal thickness was 276 µm (95-CI: 274, 278) showing no significant correlation any more in dependence of age (p=0.501) and disease duration (p=0.667). This did not reflect the situation of the ganglion cell layer or outer retinal layers and their association of the assessed factors.
When analyzing for contributing factors such as the duration of diabetes or metabolic control, it is not sufficient to focus only on overall thickness.4 Diabetic changes of inner and outer retinal layers have to be considered to be caused by different mechanisms.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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