Spectral-domain optical coherence tomography for macular edema

Emmerson Badaró, Eduardo Novais, Larissa Maria Prodocimo, Juliana M Ferraz Sallum, Emmerson Badaró, Eduardo Novais, Larissa Maria Prodocimo, Juliana M Ferraz Sallum

Abstract

Optical coherence tomography (OCT) is a rapid noncontact method that allows in vivo imaging of the retina and it has become an important component in clinical practice. OCT is a useful ancillary tool for assessing retinal diseases because of its ability to provide cross-sectional retinal images and quantitatively analyze retinal morphology. The introduction of spectral-domain OCT provided major improvements in image acquisition speed and image resolution. Future studies will address how these major technologic advances will impact the use of OCT in research and clinical practice.

Figures

Figure 1
Figure 1
A spectral domain optical coherence tomography line scan of a normal eye.
Figure 2
Figure 2
Cystoid macular edema can be seen clearly on OCT scans as multiple circular cystic spaces in the retina, indicating intraretinal edema (white arrowhead). The cystic spaces are round and originate around the outer plexiform layer.
Figure 3
Figure 3
An OCT horizontal line scan of a 62-year-old man with diabetic retinopathy and macular edema-intraretinal cysts (white arrowhead).
Figure 4
Figure 4
An OCT horizontal line scan of a woman with diabetes, with a juxtafoveal accumulation of hard exudates (white arrowhead) and substantial fluid at the level of outer plexiform layer (yellow arrowhead). Diffuse hyperreflective hard exsudates can also be seen (red arrowhead).
Figure 5
Figure 5
A line scan of an eye with macular edema secondary to an active exudative AMD. The technique allows for visualization of the cystic spaces (white arrowhead) and other changes in the retinal layers. Note the hyperreflective layer underneath the neurosensory retina suggestive of the neovascular membrane complex (yellow arrowhead).
Figure 6
Figure 6
An OCT line scan of a 73-year-old man with exudative AMD. The white arrowhead shows that the hyporeflective space below the neurosensory retina is clearly visible, suggesting the presence of fluid. Yellow arrowhead represents a hemorrhagic detachment of the retinal pigment epithelium (PED) and vitreomacular traction in addition to vitreous alterations (red arrowhead).
Figure 7
Figure 7
Macular edema in a 75-year-old woman with CRVO. There are several cystic spaces in the retinal layers (white arrowhead), although the foveal depression is preserved (yellow arrowhead).

References

    1. Huang D, Swanson EA, Lin CP, et al. Optical coherence tomography. Science. 1991;254(5035):1178–1181.
    1. Swanson EA, Izatt JA, Hee MR, et al. In vivo retinal imaging by optical coherence tomography. Optics Letters. 1993;18(21):1864–1869.
    1. Al-Latayfeh MM, Sun JK, Aiello LP. Ocular coherence tomography and diabetic eye disease. Seminars in Ophthalmology. 2010;25(5-6):192–197.
    1. Wolf S, Wolf-Schnurrbusch U. Spectral-domain optical coherence tomography use in macular diseases: a review. Ophthalmologica. 2010;224(6):333–340.
    1. Schimel AM, Fisher YL, Flynn HW., Jr. Optical coherence tomography in the diagnosis and management of diabetic macular edema: time-domain versus spectral-domain. Ophthalmic Surgery, Lasers and Imaging. 2011;42:S41–S55.
    1. Goatman KA. A reference standard for the measurement of macular oedema. British Journal of Ophthalmology. 2006;90(9):1197–1202.
    1. Goebel W, Franke R. Retinal thickness in diabetic retinopathy: comparison of optical coherence tomography, the retinal thickness analyzer, and fundus photography. Retina. 2006;26(1):49–57.
    1. Antcliff RJ, Stanford MR, Chauhan DS, et al. Comparison between optical coherence tomography and fundus fluorescein angiography for the detection of cystoid macular edema in patients with uveitis. Ophthalmology. 2000;107(3):593–599.
    1. Özdek ŞC, Erdinç MA, Gürelik G, Aydin B, Bahçeci U, Hasanreisoğlu B. Optical coherence tomographic assessment of diabetic macular edema: comparison with fluorescein angiographic and clinical findings. Ophthalmologica. 2005;219(2):86–92.
    1. Browning DJ, McOwen MD, Bowen RM, Jr., O’Marah TL. Comparison of the clinical diagnosis of diabetic macular edema with diagnosis by optical coherence tomography. Ophthalmology. 2004;111(4):712–715.
    1. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study Research Group. Archives of Ophthalmology. 1985;103(12):1796–1806.
    1. Hee MR, Puliafito CA, Duker JS, et al. Topography of diabetic macular edema with optical coherence tomography. Ophthalmology. 1998;105(2):360–370.
    1. Goebel W, Kretzchmar-Gross T. Retinal thickness in diabetic retinopathy: a study using optical coherence tomography (OCT) Retina. 2002;22(6):759–767.
    1. Klein R, Klein BEK, Moss SE. The Wisconsin epidemiologic study of diabetic retinopathy. IV. Diabetic macular edema. Ophthalmology. 1984;91(12):1464–1474.
    1. Klein R, Klein BEK, Moss SE, Cruickshanks KJ. The Wisconsin epidemiologic study of diabetic retinopathy XV: the long- term incidence of macular edema. Ophthalmology. 1995;102(1):7–16.
    1. Cunha Vaz J, Faria De Abreu JR, Campos AJ, Figo GM. Early breakdown of the blood retinal barrier in diabetes. British Journal of Ophthalmology. 1975;59(11):649–656.
    1. Nguyen QD, Tatlipinar S, Shah SM, et al. Vascular endothelial growth factor is a critical stimulus for diabetic macular edema. American Journal of Ophthalmology. 2006;142(6):961.e4–969.e4.
    1. Shah SP, Patel M, Thomas D, Aldington S, Laidlaw DAH. Factors predicting outcome of vitrectomy for diabetic macular oedema: results of a prospective study. British Journal of Ophthalmology. 2006;90(1):33–36.
    1. Otani T, Kishi S. A controlled study of vitrectomy for diabetic macular edema. American Journal of Ophthalmology. 2002;134(2):214–219.
    1. Otani T, Yamaguchi Y, Kishi S. Correlation between visual acuity and foveal microstructural changes in diabetic macular edema. Retina. 2010;30(5):774–780.
    1. Massin P, Vicaut E, Haouchine B, Erginay A, Paques M, Gaudric A. Reproducibility of retinal mapping using optical coherence tomography. Archives of Ophthalmology. 2001;119(8):1135–1142.
    1. Browning DJ, Fraser CM, Propst BW. The variation in optical coherence tomography-measured macular thickness in diabetic eyes without clinical macular edema. American Journal of Ophthalmology. 2008;145(5):889–893.
    1. Danis RP, Glassman AR, Aiello LP, et al. Diurnal variation in retinal thickening measurement by optical coherence tomography in center-involved diabetic macular edema. Archives of Ophthalmology. 2006;124(12):1701–1707.
    1. Ferris FL, III, Miller KM, Glassman AR, Beck RW. A proposed method of logarithmic transformation of optical coherence tomography data for use in clinical research. Ophthalmology. 2010;117(8):1512–1516.
    1. Diabetic Retinopathy Clinical Research Network. Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema. Ophthalmology. 2007;114(3):525–536.
    1. Chang LK, Koizumi H, Spaide RF. Disruption of the photoreceptor inner segment-outer segment junction in eyes with macular holes. Retina. 2008;28(7):969–975.
    1. Ko TH, Witkin AJ, Fujimoto JG, et al. Ultrahigh-resolution optical coherence tomography of surgically closed macular holes. Archives of Ophthalmology. 2006;124(6):827–836.
    1. Scholda C, Wirtitsch M, Hermann B, et al. Ultrahigh resolution optical coherence tomography of macular holes. Retina. 2006;26(9):1034–1041.
    1. Inoue M, Watanabe Y, Arakawa A, Sato S, Kobayashi S, Kadonosono K. Spectral-domain optical coherence tomography images of inner/outer segment junctions and macular hole surgery outcomes. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2009;247(3):325–330.
    1. The Diabetes Control. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The New England Journal of Medicine. 1993;329(14):977–986.
    1. Turner R. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) The Lancet. 1998;352(9131):837–853.
    1. Gray A, Clarke P, Farmer A, Holman R. Implementing intensive control of blood glucose concentration and blood pressure in type 2 diabetes in England: cost analysis (UKPDS 63) British Medical Journal. 2002;325(7369):860–863.
    1. Stratton IM, Cull CA, Adler AI, Matthews DR, Neil HAW, Holman RR. Additive effects of glycaemia and blood pressure exposure on risk of complications in type 2 diabetes: a prospective observational study (UKPDS 75) Diabetologia. 2006;49(8):1761–1769.
    1. Diabetic Retinopathy Clinical Research Network. Randomized trial of peribulbar triamcinolone acetonide with and without focal photocoagulation for mild diabetic macular edema: a pilot study. Ophthalmology. 2007;114(6):1190.e3–1196.e3.
    1. Diabetic Retinopathy Clinical Research Network. A randomized trial comparing intravitreal triamcinolone acetonide and focal/grid photocoagulation for diabetic macular edema. Ophthalmology. 2008;115(9):1447.e10–1459.e10.
    1. Ferrara N, Damico L, Shams N, Lowman H, Kim R. Development of ranibizumab, an anti-vascular endothelial growth factor antigen binding fragment, as therapy for neovascular age-related macular degeneration. Retina. 2006;26(8):859–870.
    1. Nguyen QD, Brown DM, Marcus DM, et al. Ranibizumab for diabetic macular edema: results from 2 phase III randomized trials: RISE and RIDE. Ophthalmology. 2012;119(4):789–801.
    1. Googe J, Brucker AJ, Bressler NM, et al. Randomized trial evaluating short-term effects of intravitreal ranibizumab or triamcinolone acetonide on macular edema after focal/grid laser for diabetic macular edema in eyes also receiving panretinal photocoagulation. Retina. 2011;31(6):1009–1027.
    1. Filho CAAG, Yehoshua Z, Gregori G, et al. Change in drusen volume as a novel clinical trial endpoint for the study of complement inhibition in age-related macular degeneration. Ophthalmic Surgery, Lasers and Imaging Retina. 2014;45(1):18–31.
    1. Doguizi S, Ozdek S. Pigment epithelial tears associated with anti-VEGF therapy: incidence, long-term visual outcome, and relationship with pigment epithelial detachment in age-related macular degeneration. Retina. 2013
    1. Coscas F, Coscas G, Souied E, Tick S, Soubrane G. Optical coherence tomography identification of occult choroidal neovascularization in age-related macular degeneration. American Journal of Ophthalmology. 2007;144(4):592.e2–599.e2.
    1. Hayreh SS. Classification of central retinal vein occlusion. Ophthalmology. 1983;90(5):458–474.
    1. Martinet V, Guigui B, Glacet-Bernard A, et al. Macular edema in central retinal vein occlusion: correlation between optical coherence tomography, angiography and visual acuity. International Ophthalmology. 2012;32(4):369–377.
    1. Ota M, Tsujikawa A, Kita M, et al. Integrity of foveal photoreceptor layer in central retinal vein occlusion. Retina. 2008;28(10):1502–1508.
    1. Murakami T, Tsujikawa A, Ohta M, et al. Photoreceptor status after resolved macular edema in branch retinal vein occlusion treated with tissue plasminogen activator. American Journal of Ophthalmology. 2007;143(1):171–173.
    1. Ota M, Tsujikawa A, Murakami T, et al. Association between integrity of foveal photoreceptor layer and visual acuity in branch retinal vein occlusion. British Journal of Ophthalmology. 2007;91(12):1644–1649.
    1. Ota M, Tsujikawa A, Murakami T, et al. Foveal photoreceptor layer in eyes with persistent cystoid macular edema associated with branch retinal vein occlusion. American Journal of Ophthalmology. 2008;145(2):273.e1–280.e1.
    1. Lima VC, Yeung L, Castro LC, Landa G, Rosen RB. Correlation between spectral domain optical coherence tomography findings and visual outcomes in central retinal vein occlusion. Clinical Ophthalmology. 2011;5(1):299–305.
    1. Iturralde D, Spaide RF, Meyerle CB, et al. Intravitreal bevacizumab (Avastin) treatment of macular edema in central retinal vein occlusion: a short-term study. Retina. 2006;26(3):279–284.
    1. Pai SA, Shetty R, Vijayan PB, et al. Clinical, anatomic, and electrophysiologic evaluation following intravitreal bevacizumab for macular edema in retinal vein occlusion. American Journal of Ophthalmology. 2007;143(4): 601.e2–606.e2.
    1. Goff MJ, Jumper JM, Yang SS, et al. Intravitreal triamcinolone acetonide treatment of macular edema associated with central retinal vein occlusion. Retina. 2006;26(8):896–901.

Source: PubMed

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