Dataset Information

Normative Data for Macular Thickness and Volume for Optical Coherence Tomography in a Diabetic Population without Maculopathies.

ABSTRACT:

Purpose

The purpose was to establish normative data for the macular thicknesses and volume using spectral-domain optical coherence tomography (SD-OCT) in a diabetic population without maculopathies for use as a reference in diabetic retinopathy (DR) and diabetic macular edema screening programs.

Methods

This was an observational study nested in a cohort of diabetics from a telemedicine DR screening program. Each patient underwent SD-OCT centered on the fovea. Macular thickness and volume were described and compared using the built-in normative database of the device. Quantile regression models for the 97.5% percentile were fitted to evaluate the predictors of macular thickness and volume.

Results

A total of 3410 eyes (mean age, 62.25 (SD, 0.22) years) were included. Mean (SD) central subfield thickness (CST) was 238.2 (23.7) µm, while center thickness (CT), average thickness (AT), and macular volume (MV) were 205.4 (31.6) µm, 263.9 (14.3) µm, and 7.46 (0.40) mm³, respectively. Para- and perifoveal thicknesses were clinically and statistically significantly thinner in our population than in the normative reference database. The 97.5% percentile of the thickness of all sectors was increased in males and in the para- and perifovea among those with DR.

Conclusions

All ETDRS sectors were thinner in patients with diabetes than in the reference population, except for the CST, which was the most stable parameter that only changed with sex. The upper cutoff limit to detect diabetic macular edema (DME) was different from that of the reference population and was influenced by conditions related to diabetes, such as DR. Therefore, specific normative data for diabetic patients should be used for the screening and diagnosis of DME using SD-OCT.

SUBMITTER: Arruabarrena C

PROVIDER: S-EPMC10455588 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Normative Data for Macular Thickness and Volume for Optical Coherence Tomography in a Diabetic Population without Maculopathies.

Arruabarrena Carolina C Rodríguez-Miguel Antonio A de Aragón-Gómez Fernando F Escámez Purificación P Rosado Ingrid I Teus Miguel A MA

Journal of clinical medicine 20230811 16

<h4>Purpose</h4>The purpose was to establish normative data for the macular thicknesses and volume using spectral-domain optical coherence tomography (SD-OCT) in a diabetic population without maculopathies for use as a reference in diabetic retinopathy (DR) and diabetic macular edema screening programs.<h4>Methods</h4>This was an observational study nested in a cohort of diabetics from a telemedicine DR screening program. Each patient underwent SD-OCT centered on the fovea. Macular thickness and ...[more]

PMID: 37629274

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Project description:ImportanceDiabetic macular edema (DME) is the predominant cause of visual impairment in patients with type 1 or 2 diabetes. Automated fluid volume measurements using optical coherence tomography (OCT) may improve the diagnostic accuracy of DME screening.ObjectiveTo assess the diagnostic accuracy of an automated central macular fluid volume (CMFV) quantification using OCT for DME.Design, setting, and participantsA cross-sectional observational study was conducted at a tertiary academic center among 215 patients with diabetes (1 eye each) enrolled from January 26, 2015, to December 23, 2019. All participants underwent comprehensive examinations, 6 × 6-mm macular structural OCT horizontal raster scans, and 6 × 6-mm macular OCT angiography volumetric scans. From January 1 to March 30, 2020, 2 retinal specialists reviewed the structural OCT scans independently and diagnosed DME if intraretinal or subretinal fluid was present. Diabetic macular edema was considered center involved if fluid was present within the central fovea (central 1-mm circle). A third retinal specialist arbitrated any discrepancy. The mean central subfield thickness (CST) within the central fovea was measured on structural OCT horizontal raster scans. A deep learning algorithm automatically quantified fluid volumes on 6 × 6-mm OCT angiography volumetric scans and within the central foveas (CMFV).Main outcomes and measuresThe area under the receiver operating characteristic curve (AUROC) and the sensitivity and specificity of CST and CMFV for DME diagnosis.ResultsWe enrolled 1 eye each of 215 patients with diabetes (117 women [54.4%]; mean [SD] age, 59.6 [12.4] years). Diabetic macular edema was present in 136 eyes; 93 cases of DME were center involved. The AUROC of CMFV for diagnosis of center-involved DME (0.907 [95% CI, 0.861-0.954]) was greater than the AUROC of CST (0.832 [95% CI, 0.775-0.889]; P = .02). With the specificity set at 95%, the sensitivity of CMFV for detection of center-involved DME (78.5% [95% CI, 68.8%-86.3%]) was higher than that of CST (53.8% [95% CI, 43.1%-64.2%]; P = .002). Center-involved DME cases not detected by CST but detected by CMFV were associated with a thinner CST (290.8 μm [95% CI, 282.3-299.3 μm] vs 369.4 μm [95% CI, 347.1-391.7 μm]; P < .001), higher proportion of previous macular laser treatment (11 of 28 [39.3%; 95% CI, 21.5%-59.4%] vs 12 of 65 [18.5%; 95% CI, 9.9%-30.0%]; P = .03), and female sex (20 of 28 [71.4%; 95% CI, 51.3%-86.8%] vs 31 of 65 [47.7%; 95% CI, 35.1%-60.5%]; P = .04).Conclusions and relevanceThese findings suggest that an automated CMFV is a more accurate diagnostic biomarker than CST for DME and may improve screening for DME.

Project description:ImportanceUnderstanding measurement variability and relationships between measurements obtained on different optical coherence tomography (OCT) machines is critical for clinical trials and clinical settings.ObjectiveTo evaluate the reproducibility of retinal thickness measurements from OCT images obtained by time-domain (TD) (Stratus; Carl Zeiss Meditec) and spectral-domain (SD) (Cirrus; Carl Zeiss Meditec, and Spectralis; Heidelberg Engineering) instruments and formulate equations to convert retinal thickness measurements from SD-OCT to equivalent values on TD-OCT.Design, setting, and participantsA cross-sectional observational study was conducted in private and institutional practices. Persons with diabetes mellitus who had at least 1 eye with central-involved diabetic macular edema, defined as Stratus central subfield thickness (CST) of 250 μm or greater, participated. An additional normative cohort (individuals with diabetes but without diabetic macular edema) was enrolled. Each study eye underwent 2 replicate Stratus scans followed by 2 replicate Cirrus or Spectralis scans (real-time image registration used) centered on the fovea.Main outcomes and measuresOptical coherence tomography CST and macular volume.ResultsThe Bland-Altman coefficient of repeatability for relative change in CST (the degree of change that could be expected from measurement variability) was lower with Spectralis (7%) compared with Cirrus (14%) and Stratus (12% and 15% within Cirrus/Stratus and Spectralis/Stratus groups, respectively). For each cohort, the initial Stratus CST was within 10% of the replicate Stratus measurement nearly all of the time; the conversion equations predicted a Stratus CST within 10% of the observed thickness 86% and 89% of the time for Cirrus/Stratus and Spectralis/Stratus groups, respectively, which is similar to the agreement on Stratus test-retest. The Bland-Altman limits of agreement for relative change in CST between machines (the degree of change that could be expected from measurement variability [combining within and between instrument variability]) were 21% for Cirrus and 19% for Spectralis when comparing predicted vs actual Stratus measurement.Conclusions and relevanceReproducibility appears to be better with Spectralis than with Cirrus and Stratus. Conversion equations to transform Cirrus or Spectralis measurements to Stratus-equivalent values, within 10% of the observed Stratus thickness values, appear feasible. Central subfield thickness changes beyond 10% when using the same machine or 20% when switching machines, after conversion to Stratus equivalents, are likely due to a change in retinal thickness rather than measurement error.

Dataset Information

Normative Data for Macular Thickness and Volume for Optical Coherence Tomography in a Diabetic Population without Maculopathies.

Purpose

Methods

Results

Conclusions

Publications

Normative Data for Macular Thickness and Volume for Optical Coherence Tomography in a Diabetic Population without Maculopathies.

Similar Datasets

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