Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema: An Attempt of Composite Grading of Macular Edema

Stela Vujosevic, Monica Varano, Catherine Egan, Sobha Sivaprasad, Geeta Menon, Ali Erginay, Frank D. Verbraak, Henrik Lund-Andersen, Jose P. Martinez, Ignasi Jürgens, Erica Smets, Caroline Coriat, Peter Wiedemann, Victor Ágoas, Giuseppe Querques, Frank G. Holz, Sandrina Nunes, Dalila Alves, Catarina Neves, Torcato SantosLuisa Ribeiro, Francesco Bandello, Amparo Navea Tejerina, José Cunha-Vaz

Research output: Contribution to journalArticle

Abstract

Purpose: To characterize the relevance of macular thickness changes in the inner and outer rings in the progression of macular edema in eyes/patients with diabetes type 2. Methods: A total of 374 type 2 diabetic patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20-35) were included in a 12-month prospective observational study to identify retinopathy progression. Retinal thickness analyses were performed in 194 eyes/patients using Cirrus SD- OCT and 166 eyes/patients using Spectralis SD-OCT. The DRCR.net classification of subclinical and clinical macular edema was used. A composite grading of macular edema is proposed in this study. Results: A total of 317 eyes/patients completed the study. SD-OCT identified clinical macular edema in 24 eyes/patients (6.7%) and subclinical macular edema in 104 eyes/patients (28.9%) at baseline. Increased thickness of the central subfield is the best predictor for the development of clinical macular edema, with 85.7% sensitivity and 71.9% specificity (OR: 2.57, 95% CI: 0.82-7.99). However, the involvement of the inner and outer rings is a cumulative predictor of progression to clinical macular edema (OR: 8.69, 95% CI: 2.85-26.52). Conclusions: A composite OCT grading of macular edema taking into account the retinal thickness changes in the inner and outer macular rings offers a simple way to characterize macular edema, with added clinical value.

Original languageEnglish
Pages (from-to)19-25
Number of pages7
JournalOphthalmic Research
Volume55
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

    Fingerprint

Keywords

  • Diabetes
  • Diabetic retinopathy
  • Macular edema
  • Optical coherence tomography

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Vujosevic, S., Varano, M., Egan, C., Sivaprasad, S., Menon, G., Erginay, A., Verbraak, F. D., Lund-Andersen, H., Martinez, J. P., Jürgens, I., Smets, E., Coriat, C., Wiedemann, P., Ágoas, V., Querques, G., Holz, F. G., Nunes, S., Alves, D., Neves, C., ... Cunha-Vaz, J. (2016). Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema: An Attempt of Composite Grading of Macular Edema. Ophthalmic Research, 55(1), 19-25. https://doi.org/10.1159/000441110