Correlation between fluorescein angiography and spectral-domain optical coherence tomography in the diagnosis of cystoid macular edema.
OBJECTIVE
To compare the ability to detect cystoid macular edema (CME) and its late complications between spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA).


METHODS
Retrospective, observational, case series. 85 Eyes who had FA and SD-OCT performed on the same day at first visit and/or at follow-up visits were included. FA and SD-OCT images were evaluated for the evidences associated with CME and other structural changes of macula. FA and SD-OCT images were then superimposed to determine the relationships of diagnostic features between the two images. Main outcome measure was the correlation between FA and SD-OCT findings of macula in patients with CME.


RESULTS
The common causes of CME in our study were retinal vein occlusion (RVO, 63%), diabetic retinopathy (DR, 21.18%) and posterior uveitis (3.53%). CME associated with RVO, age-related macular degeneration and DR were missed by FA in 18.52%, 33.33% and 33.33% of cases, respectively. Subretinal fluid was undetectable by FA in 54.55%, which mainly were in the RVO group. SD-OCT gave earlier CME diagnosis than FA in three (3.53%) eyes. Residual CME at follow-up visits were missed by FA in one (1.18%) eye. Late complications of long-standing CME (secondary macular hole (two eyes), secondary subretinal fluid (five eyes), retinal pigment epithelium detachment (one eye) and photoreceptor atrophy (one eye)) were detectable only by SD-OCT.


CONCLUSIONS
SD-OCT demonstrated greater sensitivity than FA in detecting CME, particularly those associated with RVO, DR and age-related macular degeneration. SD-OCT was also more sensitive than FA for detecting subretinal fluid and late complications of long-standing CME.
Jittpoonkuson
T
T
Retina Service, Department of Ophthalmology, Bangkok Metropolitan Administration General Hospital, 514 Luang Rd, Pomprab District, Bangkok 10100, Thailand. dr.teerapat@yahoo.com
Garcia
P M T
PM
Rosen
R B
RB
D003930:Diabetic Retinopathy / Q000150:complications; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012170:Retinal Vein Occlusion / Q000150:complications; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D015866:Uveitis, Posterior / Q000150:complications