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

Vujosevic, S; Varano, M; Egan, C; Sivaprasad, S; Menon, G; Erginay, A; Verbraak, Fd; Lund Andersen, H; Martinez, Jp; Jurgens, I; Smets, E; Coriat, C; Wiedemann, P; Agoas, V; Querques, Giuseppe; Holz, Fg; Nunes, S; Alves, D; Neves, C; Santos, T; Ribeiro, L; Bandello, Francesco; Tejerina, An; Cunha Vaz, J.

doi:10.1159/000441110

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. (C) 2015 S. Karger AG, Basel

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. (C) 2015 S. Karger AG, Basel OI Vujosevic, Stela/0000-0001-6773-9967

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 / Vujosevic, S., Varano, M., Egan, C., Sivaprasad, S., Menon, G., Erginay, A., Verbraak, F.d., Lund Andersen, H., Martinez, J.p., Jurgens, I., Smets, E., Coriat, C., Wiedemann, P., Agoas, V., Querques, G., Holz, F.g., Nunes, S., Alves, D., Neves, C., Santos, T., et al.. - In: OPHTHALMIC RESEARCH. - ISSN 0030-3747. - 55:1(2016), pp. 19-25. [10.1159/000441110]