Detection of Diabetic Foveal Edema
Contact Lens Biomicroscopy Compared With Optical Coherence Tomography
Justin C. Brown, MD;
Sharon D. Solomon, MD;
Susan B. Bressler, MD;
Andrew P. Schachat, MD;
Cathy DiBernardo, RN;
Neil M. Bressler, MD
Arch Ophthalmol. 2004;122:330-335.
Objective To compare contact lens biomicroscopy with optical coherence tomography (OCT) for the detection of diabetic foveal edema.
Methods Study participants consisted of a convenient cohort of consecutive patients with diabetes mellitus seen at the Wilmer Eye Institute's Retinal Vascular Center, Baltimore, Md. Case characteristics were recorded and eyes were examined by 1 of 4 retina specialists by means of contact lens biomicroscopy. Edema involving the center of the macula was assessed as definitely present, questionably present, or definitely not present. The OCT testing was performed and interpreted by trained technicians, masked to the physicians' assessment of foveal edema. Agreement between OCT and contact lens examination for the absence or presence of foveal edema was evaluated.
Results One hundred seventy-two eyes of 95 patients with diabetes were enrolled in August and September 2002. Foveal thickness was objectively measured by OCT in 170 (99%) of 172 cases. We found excellent agreement between OCT and contact lens examination for the absence or presence of foveal edema when OCT thickness was normal ( 200 µm) or moderately to severely increased (>300 µm). However, agreement was poor when foveal thickness was mildly increased on OCT (201-300 µm).
Conclusions Agreement between contact lens examination and OCT for the detection of diabetic foveal edema is poor when OCT thickening is mild. This suggests that contact lens biomicroscopy is relatively insensitive for the detection of mild foveal thickening apparent on OCT. Additional studies are needed to investigate the natural course of cases with mildly increased foveal thickness on OCT that do not appear thickened clinically.
From the Retinal Vascular Center, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Md. The authors have no relevant financial interest in this article.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Accuracy of retinal thickness measurements obtained with Cirrus optical coherence tomography
Keane et al.
Br J Ophthalmol 2009;93:1461-1467.
ABSTRACT
| FULL TEXT
Uveitic macular oedema: correlation between optical coherence tomography patterns with visual acuity and fluorescein angiography
Tran et al.
Br J Ophthalmol 2008;92:922-927.
ABSTRACT
| FULL TEXT
Optical Coherence Tomography versus Stereoscopic Fundus Photography or Biomicroscopy for Diagnosing Diabetic Macular Edema: A Systematic Review
Virgili et al.
IOVS 2007;48:4963-4973.
ABSTRACT
| FULL TEXT
Optimal Optical Coherence Tomography-Based Measures in the Diagnosis of Clinically Significant Macular Edema: Retinal Volume vs Foveal Thickness
Campbell et al.
Arch Ophthalmol 2007;125:619-623.
ABSTRACT
| FULL TEXT
A reference standard for the measurement of macular oedema.
Goatman
Br J Ophthalmol 2006;90:1197-1202.
ABSTRACT
| FULL TEXT
Diabetic Macular Edema: Correlation between Microperimetry and Optical Coherence Tomography Findings.
Vujosevic et al.
IOVS 2006;47:3044-3051.
ABSTRACT
| FULL TEXT
Agreement of the Heidelberg Retina Tomograph II Macula Edema Module With Fundus Biomicroscopy in Diabetic Maculopathy.
Kisilevsky et al.
Arch Ophthalmol 2006;124:337-342.
ABSTRACT
| FULL TEXT
Normal macular thickness measurements in healthy eyes using stratus optical coherence tomography.
Chan et al.
Arch Ophthalmol 2006;124:193-198.
ABSTRACT
| FULL TEXT
A Standardized Method for Reporting Changes in Macular Thickening Using Optical Coherence Tomography
Chan and Duker
Arch Ophthalmol 2005;123:939-943.
ABSTRACT
| FULL TEXT
|
