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Nathan Cutler, Abtin Shahlaee, Murtaza K Adam, Jason Hsu; Effectiveness of en face spectral domain optical coherence tomography for detection of diabetic macular edema. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1656.
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© ARVO (1962-2015); The Authors (2016-present)
Spectral domain optical coherence tomography (SD-OCT) is the primary imaging modality for diagnosing and following diabetic macular edema (DME). Advances in retinal imaging techniques now allows en face images of SD-OCT scans which have the potential to improve detection of retinal diseases. We performed a retrospective, observational clinical study to examine the effectiveness of the automated segmentation en face scan patterns in detecting intraretinal and subretinal fluid in DME.
Between November, 2014 and March, 2016, a total of 173 eyes were imaged on the same day with both Avanti RTVue XR optical coherence tomography angiography (Optovue Inc., Fremont, CA) with superficial retinal, deep retinal, outer retinal, and choriocapillaris automated segmentation and Spectralis SD-OCT (Heidelberg Engineering Inc., Heidelberg, Germany) with macular 30 degree, 25-line horizontal raster image acquisition scan patterns. Scans were read by two independent graders and interobserver differences were reconciled by an independent third grader. Sensitivity of fluid detection for the en face scans was determined by using a combination of Avanti 304-line macular cube and Spectralis 25-line raster scans as a gold standard.
A total of 244 en face and 25-line radial SD-OCT scans were interpreted (mean: 1.41 scans/eye). 168 scans (68.9%) had confirmed fluid on SD-OCT. The en face scan pattern fluid detection sensitivity was 93.5% and specificity was 47.4%. Inter-rater reliability for fluid detection was 78.7% for the en face scans and 91.0% for the SD-OCT scans.
The en face SD-OCT scanning protocol alone with automated segmentation is highly sensitive, but not specific in detecting the presence of intraretinal and subretinal fluid in DME. Positive en face scan findings should be correlated with additional OCT scan protocols to guide clinical decision making.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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