Correlation between morphologic features on spectral-domain optical coherence tomography and angiographic leakage patterns in macular edema.
OBJECTIVE
The purpose of this study was to determine the morphologic patterns of angiographic macular edema using simultaneous colocalization of fluorescein angiography and spectral-domain optical coherence tomography (SD-OCT) images in diabetes, epiretinal membrane, uveitic and pseudophakic cystoid macular edema, and vein occlusion.


METHODS
Eighty-seven consecutive patients (107 eyes) with macular edema from 5 different etiologies were imaged by simultaneous scanning laser ophthalmoscopy/OCT to study the morphologic patterns of edema on SD-OCT and then correlated/colocalized with the fluorescein angiographic patterns of leakage. Statistical analysis was done to analyze the differences in the morphologic OCT pattern by different diseases.


RESULTS
Spectral-domain OCT characteristics of macular edema showed a significant difference across different diseases (P = 0.037). Cystic fluid pockets were found to be more commonly seen in patients with diabetic macular edema and retinal vein occlusions, whereas those cases with macular edema secondary to epiretinal membrane showed noncystic changes on OCT. Seventy of the 107 eyes had diffuse angiographic leakage, and the remaining 37 eyes had cystoid leakage on angiography. Of the 70 eyes with diffuse leakage, 24.28% showed microcysts on SD-OCT in the area of edema, and 70% eyes had diffuse thickening or distorted architecture without cyst. All 37 eyes with cystoid leakage showed cysts in the area of edema by SD-OCT. A total of 3.73% of eyes with fluorescein angiographic leakage had no abnormalities on SD-OCT.


CONCLUSIONS
Eyes with diabetic macular edema and retinal vein occlusions have a significantly higher incidence of cyst formation on SD-OCT. There was no correlation between visual acuity and cyst formation. Diffuse noncystoid angiographic macular edema may show microcysts on SD-OCT, but diffuse edema is more commonly associated with thickening or distortion of the retinal layers without cyst formation. Cystoid leakage on fluorescein angiography is always associated with cystic changes on SD-OCT.
Brar
Manpreet
M
Department of Ophthalmology, University of California San Diego, Shiley Eye Center, 0946, Joan and Irwin Jacobs Retina Center, 9415 Campus Point Drive, La Jolla, CA 92037, USA.
Yuson
Ritchie
R
Kozak
Igor
I
Mojana
Francesca
F
Cheng
Lingyun
L
Bartsch
Dirk-Uwe
DU
Oster
Stephen F
SF
Freeman
William R
WR
D002199:Capillary Permeability; D003930:Diabetic Retinopathy / Q000150:complications; D019773:Epiretinal Membrane / Q000150:complications; D005451:Fluorescein Angiography; D006801:Humans; D008266:Macula Lutea / Q000473:pathology* / Q000503:physiopathology; D008269:Macular Edema / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D019591:Pseudophakia / Q000150:complications; D012170:Retinal Vein Occlusion / Q000150:complications; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014605:Uveitis / Q000150:complications; D014792:Visual Acuity / Q000502:physiology