Correlation between fluorescein angiography and spectral-domain optical coherence tomography in the diagnosis of cystoid macular edema. 2010

T Jittpoonkuson, and P M T Garcia, and R B Rosen
Retina Service, Department of Ophthalmology, Bangkok Metropolitan Administration General Hospital, 514 Luang Rd, Pomprab District, Bangkok 10100, Thailand. dr.teerapat@yahoo.com

OBJECTIVE To compare the ability to detect cystoid macular edema (CME) and its late complications between spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA). METHODS Retrospective, observational, case series. 85 Eyes who had FA and SD-OCT performed on the same day at first visit and/or at follow-up visits were included. FA and SD-OCT images were evaluated for the evidences associated with CME and other structural changes of macula. FA and SD-OCT images were then superimposed to determine the relationships of diagnostic features between the two images. Main outcome measure was the correlation between FA and SD-OCT findings of macula in patients with CME. RESULTS The common causes of CME in our study were retinal vein occlusion (RVO, 63%), diabetic retinopathy (DR, 21.18%) and posterior uveitis (3.53%). CME associated with RVO, age-related macular degeneration and DR were missed by FA in 18.52%, 33.33% and 33.33% of cases, respectively. Subretinal fluid was undetectable by FA in 54.55%, which mainly were in the RVO group. SD-OCT gave earlier CME diagnosis than FA in three (3.53%) eyes. Residual CME at follow-up visits were missed by FA in one (1.18%) eye. Late complications of long-standing CME (secondary macular hole (two eyes), secondary subretinal fluid (five eyes), retinal pigment epithelium detachment (one eye) and photoreceptor atrophy (one eye)) were detectable only by SD-OCT. CONCLUSIONS SD-OCT demonstrated greater sensitivity than FA in detecting CME, particularly those associated with RVO, DR and age-related macular degeneration. SD-OCT was also more sensitive than FA for detecting subretinal fluid and late complications of long-standing CME.

UI MeSH Term Description Entries
D008269 Macular Edema Fluid accumulation in the outer layer of the MACULA LUTEA that results from intraocular or systemic insults. It may develop in a diffuse pattern where the macula appears thickened or it may acquire the characteristic petaloid appearance referred to as cystoid macular edema. Although macular edema may be associated with various underlying conditions, it is most commonly seen following intraocular surgery, venous occlusive disease, DIABETIC RETINOPATHY, and posterior segment inflammatory disease. (From Survey of Ophthalmology 2004; 49(5) 470-90) Central Retinal Edema, Cystoid,Cystoid Macular Edema,Macular Edema, Cystoid,Cystoid Macular Dystrophy,Cystoid Macular Edema, Postoperative,Irvine-Gass Syndrome,Macular Dystrophy, Dominant Cystoid,Edema, Cystoid Macular,Edema, Macular,Irvine Gass Syndrome,Syndrome, Irvine-Gass
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003930 Diabetic Retinopathy Disease of the RETINA as a complication of DIABETES MELLITUS. It is characterized by the progressive microvascular complications, such as ANEURYSM, interretinal EDEMA, and intraocular PATHOLOGIC NEOVASCULARIZATION. Diabetic Retinopathies,Retinopathies, Diabetic,Retinopathy, Diabetic
D005260 Female Females
D005451 Fluorescein Angiography Visualization of a vascular system after intravenous injection of a fluorescein solution. The images may be photographed or televised. It is used especially in studying the retinal and uveal vasculature. Fluorescence Angiography,Fundus Fluorescence Photography,Angiography, Fluorescein,Angiography, Fluorescence,Fluorescence Photography, Fundus,Photography, Fundus Fluorescence
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012170 Retinal Vein Occlusion Blockage of the RETINAL VEIN. Those at high risk for this condition include patients with HYPERTENSION; DIABETES MELLITUS; ATHEROSCLEROSIS; and other CARDIOVASCULAR DISEASES. Branch Retinal Vein Occlusion,Branch Vein Occlusion,Central Retinal Vein Occlusion,Retinal Branch Vein Occlusion,Thrombosis, Retinal Vein,Retinal Vein Thrombosis,Branch Vein Occlusions,Occlusion, Branch Vein,Occlusion, Retinal Vein,Retinal Vein Occlusions,Retinal Vein Thromboses,Vein Occlusion, Branch,Vein Occlusion, Retinal,Vein Thrombosis, Retinal
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity

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