Representativity of macular edema mapping using en face optical coherence tomography, retinal thickness map, and fluorescein angiography

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Abstract

Aim. To study the representativity of macular edema mapping using en face optical coherence tomography (OCT), retinal thickness map, and fluorescein angiography (FA). 

Methods. In this retrospective cross-sectional study, 8 patients (15 eyes) with diabetic macular edema (2 females and 6 males, mean age 66.5 ± 8.1 years) were included. All patients OCT (retinal thickness map and en face OCT) and FA were performed. En face slab was constructed between inner plexiform layer and retinal pigment epithelium. The area of macular edema was measured by two masked graders independently. 

Results. There was no statistically significant difference in the area of macular edema between FA, en face OCT, and retinal thickness maps, 12.7 ± 8.1, 14.5 ± 8.4, 10.4 ± 6.9 mm2, respectively (ANOVA × 3, p = 0.34). Intraclass correlation coefficient for three methods was 0.87 and 0.95, for individual and mean values, respectively. 

Conclusion. En face OCT is an adequate non-invasive alternative for FA in evaluating the area of macular edema and planning of grid macular laser photocoagulation.

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About the authors

Dmitrii S. Maltsev

S.M. Kirov Military Medical Academy

Author for correspondence.
Email: glaz.med@yandex.ru
ORCID iD: 0000-0001-6598-3982

MD, PhD, Head of Medical Retina Division of Ophthalmology Department

Russian Federation, Saint Petersburg

Alexey N. Kulikov

S.M. Kirov Military Medical Academy

Email: alexey.kulikov@mail.ru

MD, DSc, head of ophthalmology department

Russian Federation, Saint Petersburg

Alina A. Kazak

S.M. Kirov Military Medical Academy

Email: ali-kazak@mail.ru

Medical student

Russian Federation, Saint Petersburg

Alexander S. Vasiliev

S.M. Kirov Military Medical Academy

Email: shizolamp@gmail.com

MD, Ophthalmologist of the Ophthalmology Department

Russian Federation, Saint Petersburg

References

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  10. Maltsev DS, Kulikov AN, Burnasheva MA, et al. Structural en face optical coherence tomography imaging for identification of leaky microaneurysms in diabetic macular edema. Int Ophthalmol. 2020;40(4):787-794. https://doi.org/10.1007/s10792-019-01239-w.

Supplementary files

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2. Fig. 1. Dot-plot showing differences in the area of macular edema between fluorescein angiography images, en face optical coherence tomography images, and retinal thickness maps

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3. Fig. 2. Visualization of macular edema area using fluorescein angiography, en face optical coherence tomography, and retinal thickness mapping in eyes with focal fovea-involving macular edema (а–с): a – according to the masked grader’s estimation, based on fluorescein angiography (FA), the area of macular edema was 7.5 mm2, b – based on en face optical coherence tomography (OCT) the area of macular edema was 6.4 mm2, c – based on retinal thickness map the area of macular edema was 4.8 mm2; and fovea-sparing (d–f) flat macular edema: d – based on fluorescein angiography (FA) the area of macular edema was 1.5 mm2; e – based on en face optical coherence tomography (OCT) the area of macular edema was 2.4 mm2; f – based on retinal thickness map a masked grader failed to delineate the area of macular edema

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4. Fig. 3. Bland – Altman plot showing differences in macular edema area measured based on fluorescein angiography and en face optical coherence tomography images

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5. Fig. 4. Bland – Altman plot showing differences in macular edema area measured based on fluorescein angiography images and retinal thickness maps

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Copyright (c) 2020 Maltsev D.S., Kulikov A.N., Kazak A.A., Vasiliev A.S.

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