Detection of diabetic foveal edema - Contact lens biomicroscopy compared with optical coherence tomography
Detection of diabetic foveal edema - Contact lens biomicroscopy compared with optical coherence tomography
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DOI：
10.1001/archopht.122.3.330
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发表时间：
2004-03-01
影响因子：
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通讯作者：
Bressler, NM
中科院分区：
文献类型：
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作者：
Brown, JC;Solomon, SD;Bressler, NM
目的：比较隐形眼镜生物显微镜与光学相干断层扫描 (OCT) 检测糖尿病性黄斑中心凹水肿的效果。方法：研究参与者由在马里兰州巴尔的摩威尔默眼科研究所视网膜血管中心就诊的连续糖尿病患者组成。记录病例特征，并由 4 名视网膜专家中的 1 名通过隐形眼镜生物显微镜检查眼睛。涉及黄斑中心的水肿被评估为肯定存在、可疑存在或绝对不存在。 OCT 测试由经过培训的技术人员进行和解释，掩盖了医生对中心凹水肿的评估。评估 OCT 和隐形眼镜检查是否存在黄斑中心凹水肿的一致性。 结果：2002 年 8 月和 9 月纳入 95 名糖尿病患者的 172 只眼睛。172 例中的 170 例（99%）通过 OCT 客观测量了黄斑中心凹厚度。我们发现，当 OCT 厚度正常（小于或等于 200 μm）或中度至严重增加（>300 μm）时，OCT 和隐形眼镜检查对于是否存在黄斑中心凹水肿具有极好的一致性。然而，当 OCT 上黄斑中心凹厚度轻度增加（201-300 mm）时，一致性较差。结论：当 OCT 轻度增厚时，隐形眼镜检查与 OCT 在检测糖尿病黄斑中心凹水肿方面的一致性较差。这表明隐形眼镜生物显微镜对于检测 OCT 上明显的轻度中心凹增厚相对不敏感。需要进行更多研究来调查 OCT 上中心凹厚度轻度增加但临床上未出现增厚的病例的自然病程。
Objective: To compare contact lens biomicroscopy with optical coherence tomography (OCT) for the detection of diabetic foveal edema.Methods: Study participants consisted of a convenient cohort of consecutive patients with diabetes mellitus seen at the Wilmer Eye Institute's Retinal Vascular Center, Baltimore, Md. Case characteristics were recorded and eyes were examined by I of 4 retina specialists by means of contact lens biomicroscopy. Edema involving the center of the macula was assessed as definitely present, questionably present, or definitely not present. The OCT testing was performed and interpreted by trained technicians, masked to the physicians' assessment of foveal edema. Agreement between OCT and contact lens examination for the absence or presence of foveal edema was evaluated.Results: One hundred seventy-two eyes of 95 patients with diabetes were enrolled in August and September 2002. Foveal thickness was objectively measured by OCT in 170 (99%) of 172 cases. We found excellent agreement between OCT and contact lens examination for the absence or presence of foveal edema when OCT thickness was normal (less than or equal to200 mum) or moderately to severely increased (>300 mum). However, agreement was poor when foveal thickness was mildly increased on OCT (201-300 mum).Conclusions: Agreement between contact lens examination and OCT for the detection of diabetic foveal edema is poor when OCT thickening is mild. This suggests that contact lens biomicroscopy is relatively insensitive for the detection of mild foveal thickening apparent on OCT. Additional studies are needed to investigate the natural course of cases with mildly increased foveal thickness on OCT that do not appear thickened clinically.