Retinal Thickness in People with Diabetes and Minimal or No Diabetic Retinopathy: Heidelberg Spectralis Optical Coherence Tomography

Chalam, Kakarla V.; Bressler, Susan B.; Edwards, Allison R.; Berger, Brian B.; Bressler, Neil M.; Glassman, Adam R.; Grover, Sandeep; Gupta, Shailesh Kumar; Nielsen, Jared S.

doi:10.1167/iovs.12-10290

Cited by 134 publications

(120 citation statements)

References 9 publications

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“…In the central subfield 24 eyes/patients (6.7%, corresponding to 6.2%, 95% CI: 2.8-9.6, with the Cirrus and 7.2%, 95% CI: 3.3-11.2, with the Spectralis) had an OCT diagnosis of clinical macular edema at baseline, according to the DRCR.net standards [6]. Subclinical macular edema was identified in 104 eyes/patients (28.9%, corresponding to 32.0%, 95% CI: 25.4-38.5, with the Cirrus and 25.3%, 95% CI: 18.7-31.9, with the Spectralis).…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2015

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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.

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Section: Resultsmentioning

confidence: 99%

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

et al. 2015

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“…The sample size calculation was based on the rate of NV regression at month 12 (primary outcome), assuming a 25% rate for the PRP group and a 90% rate for the IVR and the PRP + IVR groups [21,22], with a 10% dropout rate, a 2-sided significance of 0.01 and a power of 0.9.…”

Section: Methodsmentioning

confidence: 99%

Ranibizumab for High-Risk Proliferative Diabetic Retinopathy: An Exploratory Randomized Controlled Trial

Figueira¹,

Silva²,

Henriques³

et al. 2015

Ophthalmologica

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Purpose: To compare the efficacy and safety of intravitreal ranibizumab (IVR) in monotherapy or associated with panretinal photocoagulation (PRP) versus conventional PRP, for high-risk proliferative diabetic retinopathy (PDR) without vitreoretinal traction. Procedures: Multicenter randomized trial, with 3 treatment arms: PRP versus IVR alone and PRP + IVR combined treatment. Follow-up was performed at months 3, 6 and 12. Results: Thirty-five subjects were randomized and 32 used for analysis. Complete regression of neovessels elsewhere occurred in 100% (PRP + IVR), 75% (IVR) and 69.2% (PRP) and for neovessels of the disk in 44.4% (PRP + IVR), 37.5% (IVR) and 30.8% (PRP). During the 1-year duration of treatment, there was no need for laser rescue treatment in IVR-treated eyes. Conclusions: This trial suggests that the use of IVR is safe and may have a beneficial effect in the treatment of eyes with high-risk PDR. Message: Ranibizumab appears to have a place in the treatment of PDR.

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“…In the central subfield, 12 eyes/patients (6.2%; 95% confidence interval, CI: 2.8-9.6%) had an OCT diagnosis of clinical macular edema, according to the DRCR.net standards [8] . Subclinical macular edema was identified in 62 eyes/patients (32.0%; 95% CI: 25.4-38.5%).…”

Section: Retinal Thicknessmentioning

confidence: 99%

Retinal Layer Location of Increased Retinal Thickness in Eyes with Subclinical and Clinical Macular Edema in Diabetes Type 2

et al. 2015

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Purpose: To identify the retinal layer predominantly affected in eyes with subclinical and clinical macular edema in diabetes type 2. Methods: A cohort of 194 type 2 diabetic eyes/patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20/35) were examined with Cirrus spectral-domain optical coherence tomography (OCT) at the baseline visit (ClinicalTrials.gov identifier: NCT01145599). Automated segmentation of the retinal layers of the eyes with subclinical and clinical macular edema was compared with a sample of 31 eyes from diabetic patients with normal OCT and an age-matched control group of 58 healthy eyes. Results: From the 194 eyes in the study, 62 had subclinical macular edema and 12 had clinical macular edema. The highest increases in retinal thickness (RT) were found in the inner nuclear layer (INL; 33.6% in subclinical macular edema and 81.8% in clinical macular edema). Increases were also found in the neighboring layers. Thinning of the retina was registered in the retinal nerve fiber, ganglion cells and inner plexiform layers in the diabetic eyes without macular edema. Conclusions: The increase in RT occurring in diabetic eyes with macular edema is predominantly located in the INL but extends to neighboring retinal layers indicating that it may be due to extracellular fluid accumulation.

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Retinal Thickness in People with Diabetes and Minimal or No Diabetic Retinopathy: Heidelberg Spectralis Optical Coherence Tomography

Cited by 134 publications

References 9 publications

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

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

Ranibizumab for High-Risk Proliferative Diabetic Retinopathy: An Exploratory Randomized Controlled Trial

Retinal Layer Location of Increased Retinal Thickness in Eyes with Subclinical and Clinical Macular Edema in Diabetes Type 2

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