scholarly journals Sub-clinical thickening of the fovea in diabetes and its relationship to glycaemic control: a study using swept-source optical coherence tomography

2020 ◽  
Author(s):  
Ross T. Aitchison ◽  
Graeme J. Kennedy ◽  
Xinhua Shu ◽  
David C. Mansfield ◽  
Uma Shahani
Keyword(s):  
Optical Coherence Tomography ◽  
Glycaemic Control ◽  
Macular Oedema ◽  
Linear Regression Analysis ◽  
Blood Glucose Control ◽  
Diabetic Group ◽  
Cystoid Macular Oedema ◽  
Optical Coherence ◽  
Swept Source ◽  
Macular Volume

Abstract Background Accumulation of multiple pockets of fluid at the fovea, as a complication of poor blood glucose control in diabetes, causes impairment of central vision. A new ability to demonstrate a pre-clinical phase of this maculopathy could be valuable, enabling diabetic individuals to be alerted to the need to improve their glycaemic control. This study aimed to use swept-source optical coherence tomography (SS-OCT) to measure foveal thickness and macular volume in diabetic individuals without cystoid macular oedema, and in non-diabetic individuals, and relate these measures to participants’ glycaemic control. Methods Centre point thickness (CPT) and total macular volume (TMV) were measured using SS-OCT (DRI OCT Triton™, Topcon, Tokyo, Japan). Participants’ glycosylated haemoglobin (HbA1c) level was also assessed (A1cNow®+ System, PTS Diagnostics, Indianapolis, IN, USA). The diabetic (n = 27) and non-diabetic (n = 27) groups were matched for age (p = 0.100) and sex (p = 0.414), and HbA1c level differed between diabetic and non-diabetic groups (p < 0.0005). The diabetic group comprised type 1 (n = 7) and type 2 (n = 20) diabetic individuals who were matched for duration of diabetes (p = 0.617) and whose glycaemic control was similar (p = 0.814). Results Diabetic individuals had significantly higher CPT (t(37) = 3.859, p < 0.0005) than non-diabetic individuals. In the diabetic group, multiple linear regression analysis revealed a conspicuous relationship between CPT and HbA1c level (β = 0.501, t(21) = 3.139, p = 0.005): there was a 19-μm increase in CPT for each 1% increase in HbA1c level. This relationship was not present in the non-diabetic group (β = − 0.068, t(23) = − 0.373, p = 0.712). Conclusions SS-OCT is the only way to measure macular thickness in vivo. Diabetic individuals en bloc had higher CPT compared with non-diabetic individuals. Moreover, in the diabetic group, HbA1c level significantly predicted CPT. Our results suggest that, in diabetes, sub-clinical thickening may occur at the fovea before cystoid macular oedema becomes clinically evident. This could provide diabetic individuals with an early warning of disease progression and motivate them to improve control of their diabetes, with a view to avoiding the need of intra-vitreal injections with their attendant risks.

scholarly journals Comparison between Optical Coherence Tomography and Fundus Fluorescein Angiography in the Detection of Cystoid Macular Oedema in a Tertiary Eye Care Centre in Nagpur, Maharashtra

2021 ◽  
Vol 8 (40) ◽  
pp. 3459-3463
Author(s):  
Kavita Anand Dhabarde ◽  
Karuna Radhakishan Painjane ◽  
Ashok Hukumchand Madan
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Vein Occlusion ◽  
Macular Oedema ◽  
Cystoid Macular Oedema ◽  
Optical Coherence ◽  
Age Group ◽  
Care Centre ◽  
Eye Care ◽  
Fundus Fluorescein Angiography ◽  
Vein Occlusion

BACKGROUND Fundus fluorescin angiography (FFA) has been traditional gold standard for detection of cystoid macular oedema (CME) but nowadays optical coherence tomography (OCT) is used more often by to detect CME due to various conditions. Although FFA can assess CME qualitatively, OCT provides quantitative measurement of foveal thickness. The purpose of this study is to compare sensitivity of FFA and OCT for detection of CME and know the etiological distribution of CME and the ability of FFA and OCT in diagnosing CME in different aetiologies. METHODS A hospital based prospective observational diagnostic study was conducted in tertiary eye care centre in central India on 143 eyes of 103 patients. FFA and OCT findings in patients of CME diagnosed provisionally on fundus examination were studied. RESULTS Of total 103 patients studied, maximum patients 20 (19.42 %) were in age group of 55 - 59 years whereas minimum 6 (5.83 %) were in age group of 40 - 44 years. In 103 patients, 61 (59.22 %) were males and 42 (40.78 %) were females. Both eyes were involved in 41 (40.78 %) cases. Most common cause of CME was nonproliferative diabetic retinopathy (NPDR) 52 eyes (35.86 %), followed by branch retinal vein occlusion (BRVO) 32 eyes (22.06 %), then proliferative diabetic retinopathy (PDR) 14 eyes (9.6 %), central retinal vein occlusion (CRVO) 13 eyes (8.96 %). CME on OCT was seen in maximum of retinal vein occlusion patients - CRVO (84.61 %) and BRVO (84.37 %). Of 145 eyes, 114 (78.32 %) eyes had CME. CONCLUSIONS Most common cause of CME was NPDR followed by BRVO, PDR and CRVO. Sensitivity of OCT in comparison with FFA was 100 % with diagnostic accuracy of 81.38 %. Hence, one can use OCT as first modality investigation for diagnosis of CME. KEYWORDS Optical Coherence Tomography, Fundus Fluorescein Angiography, Cystoid Macular Oedema, NPDR

Optical coherence tomography angiography in pseudophakic cystoid macular oedema compared to diabetic macular oedema: qualitative and quantitative evaluation of retinal vasculature

2018 ◽  
Vol 102 (12) ◽  
pp. 1684-1690 ◽  
Author(s):  
Riccardo Sacconi ◽  
Eleonora Corbelli ◽  
Adriano Carnevali ◽  
Stefano Mercuri ◽  
Alessandro Rabiolo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Oedema ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Macular Oedema ◽  
Foveal Avascular Zone ◽  
Cystoid Macular Oedema ◽  
Control Group ◽  
Retinal Vasculature ◽  
Ophthalmological Examination ◽  
Optical Coherence

AimsTo describe optical coherence tomography angiography (OCT-A) abnormalities of patients with pseudophakic cystoid macular oedema (PCMO) before and after pharmacological resolution, compared with diabetic macular oedema (DMO) and normal eyes.MethodsIn this retrospective, observational study, 44 eyes (30 patients) were included: 15 eyes (15 patients) affected by PCMO; 14 healthy fellow eyes used as negative control group; 15 eyes (15 age-matched and sex-matched patients) with DMO used as positive control group. All patients underwent a complete ophthalmological examination at baseline, including OCT-A scans of the macula through AngioPlex CIRRUS-5000 (Carl Zeiss Meditec, Dublin, USA). Patients with PCMO and DMO were re-evaluated after the pharmacological resolution of cystoid macular oedema (CMO).ResultsDisruption of parafoveal capillary arcade and cystoid spaces in deep capillary plexus (DCP) were frequent in patients with PCMO and DMO (73% and 100%, 87% and 100%). Capillary abnormalities and non-perfusion greyish areas in DCP were more frequent in DMO (P<0.001 and P=0.014). Patients with PCMO showed a larger foveal avascular zone area in DCP at baseline (P<0.001), which significantly reduced after treatment (P=0.001). Vessel density of full-thickness retina and DCP was reduced in patients with PCMO (P=0.022 and P=0.001), and no changes were observed after treatment. Interestingly, DCP appeared less represented in patients with DMO than PCMO subjects (P=0.001).ConclusionsPatients with PCMO have an impairment of mainly DCP, partially reversible after treatment. Furthermore, we disclosed that different alterations of the retinal vasculature characterise CMO derived from two different diseases, namely PCMO and DMO, and this could be due to their distinct pathophysiology.

Systematic ultrastructural comparison of swept-source and full-depth spectral domain optical coherence tomography imaging of diabetic macular oedema

2019 ◽  
Vol 104 (6) ◽  
pp. 868-873 ◽  
Author(s):  
Christoph Mitsch ◽  
Jan Lammer ◽  
Sonja Karst ◽  
Christoph Scholda ◽  
Eleonore Pablik ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Layer Thickness ◽  
Macular Oedema ◽  
Diabetic Macular Oedema ◽  
Spectral Domain ◽  
Retinal Layer ◽  
Systematic Bias ◽  
Optical Coherence ◽  
Swept Source ◽  
Sd Oct

Background/AimsOptical coherence tomography (OCT) is commonly used to diagnose and assess diabetic macular oedema (DME). Swept-source OCT (SS-OCT) promises improved imaging depth and more independence from media opacities. Heidelberg Spectralis full-depth imaging (FDI) combines details at different depths to one representation. The aim of this study was to determine the comparability of the imaging methods concerning DME ultrastructure.MethodsTwo graders assessed the presence of typical DME phenomena in eyes with centre-involving DME on Topcon Atlantis SS-OCT and Heidelberg Spectralis FDI spectral-domain OCT (SD-OCT) B-scans. Retinal layer segmentation was corrected and choroidal layers were manually segmented. Graders measured cyst and subretinal fluid (SRF) diameters and counted hyper-reflective foci (HRF). Findings were recorded and statistically analysed.ResultsStatistically significant systematic biases (Spectralis-Atlantis) were found for the HRF count (outside the central mm, −6.39, p=0.0338), chorioretinal thickness (central mm: −35.45 µm, p=0.00034), choroidal thickness (central mm: −60.97 µm, p=0.00004) and Sattler’s layer thickness (−42.69 µm, p=0.0001). Intergrader agreement was excellent or very good for posterior vitreous detachment, vitreomacular attachment (central mm) and SRF presence in both devices. Manually delineated Sattler’s layer thickness showed an intraclass correlation of 0.85 with FDI SD-OCT but 0.26 with SS-OCT (p=0.003).ConclusionProminent aspects such as cysts in the outer nuclear layer and SRF can be identified with comparable confidence, while a significant systematic bias underlies chorioretinal, choroidal and Sattler’s layer thickness and HRF count. Specialists should use the same device at every examination during longitudinal clinical consideration or cross-sectional evaluation of these ultrastructural biomarkers.

scholarly journals Comparison of Macular Thickness Measurements Using Swept-Source and Spectral-Domain Optical Coherence Tomography in Healthy and Diabetic Subjects

2020 ◽  
Author(s):  
Kun Xiong ◽  
Wei Wang ◽  
Xia Gong ◽  
Wangting Li ◽  
Yuting Li ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Thickness ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Swept Source ◽  
Macular Volume ◽  
Conversion Equation ◽  
Thickness Measurements ◽  
Sd Oct

AbstractPurposeTo compare macular thicknesses measured using swept-source optical coherence tomography (SS-OCT) and spectral domain OCT (SD-OCT) in normal subjects, diabetics with diabetic retinopathy (DR) and diabetics without DR (NDR).MethodsWe analysed 510 normal eyes, 741 NDR eyes and 209 DR eyes. Mean macular thicknesses in Early Treatment Diabetic Retinopathy Study (ETDRS) subfields, central point thicknesses (CPT), and macular volume were measured by SS-OCT and SD-OCT. We assessed agreement between SS-OCT and SD-OCT measurements by intraclass correlation coefficients (ICC) and Bland-Altman plots, and established a conversion equation relating central subfield (CSF), CPT and macular volume between the two devices.ResultsMacular thickness measurements by SS-OCT were significantly thinner than those by SD-OCT. The mean CSF thickness in normal eyes measured by SD-OCT and SS-OCT were 226.6 ± 19.1 μm (male 236.1 ± 19.1 μm vs female 223.0 ± 17.9 μm, p < 0.0001) and 258.4 ± 19.8 μm. In all three groups, the agreement between SS-OCT and SD-OCT was excellent (all ICC ≥ 0.866). For CSF the conversion equation SD-OCT = 31.95 + 0.999 × SS-OCT was derived. Using the equation, with 99.6% and 97.6% of the predicted values for CSF fell within 10% of the actual measurements in DR and NDR eyes, respectively.ConclusionWe propose SS-OCT CSF thicknesses of 275 μm for males and 260 μm for females as the minimum criteria for macular edema in Chinese eyes. And SS-OCT measurements were significantly thinner than those of SD-OCT, we derived an equation to convert SS-OCT measurements to SD-OCT equivalents.

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