title: Predicting visual outcomes for macular disease using optical coherence tomography.
abstract: In recent years, the management of macular disease has undergone radical changes, in part because of new therapeutic approaches, but also due to the introduction of a new imaging modality - optical coherence tomography (OCT). The application of OCT imaging has clarified many aspects of chorioretinal disease pathophysiology and elucidated many hitherto unrecognized disease characteristics. From an early stage in its development, OCT has also been revolutionary in attempting to extract clinically useful measurements from image data in an automated fashion. As a result, OCT-derived measurements of retinal thickness have been rapidly embraced in clinical and research settings. However, as knowledge of OCT image analysis has developed, it has become increasingly clear that even accurate measurements of retinal thickness may fail to predict visual outcomes for many diseases. As a result, the focus of much current clinical imaging research is on the identification of other OCT-derived anatomic biomarkers predictive of visual outcomes - such biomarkers could serve as surrogate endpoints in clinical trials and provide prognostic information in clinical practice. In this review, we begin by highlighting the importance of accurate visual function assessment and describing the fundamentals of OCT image evaluation, before describing the current state-of-the-art with regard to predicting visual outcomes, for a variety of macular diseases, using OCT.
authors: NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, United Kingdom.
authors: Pearse A
authors: PA
authors: Keane
authors: Srinivas R
authors: SR
authors: Sadda
keywords: AMD, age-related macular degeneration; Age-related macular degeneration; BRVO, branch retinal vein occlusion; CME, cystoid macular edema; CNV, choroidal neovascularization; CRVO, central retinal vein occlusion; CSC, central serous chorioretinopathy; Central serous chorioretinopathy; Contrast sensitivity; DME, diabetic macular edema; Diabetic macular edema; ELM, external limiting membrane; ERM, epiretinal membrane; ETDRS, Early Treatment Diabetic Retinopathy Study; GA, geographic atrophy; Geographic atrophy; IS–OS, inner segment–outer segment; MPS, Macular Photocoagulation Study; Microperimetry; OCT, optical coherence tomography; Optical coherence tomography; PED, pigment epithelium detachment; RPE, retinal pigment epithelium; Surrogate endpoints; Visual acuity; logMAR, logarithm of the minimum angle of resolution
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