Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema
Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema
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DOI：
10.1016/j.ophtha.2006.06.052
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发表时间：
2007-03-01
期刊：
影响因子：
13.7
通讯作者：
Miskala, Paivi H.
中科院分区：
文献类型：
--
作者：
Browning, David J.;Glassman, Adam R.;Miskala, Paivi H.
目的：比较糖尿病性黄斑水肿（DME）患者黄斑激光光凝前后光学相干断层扫描（OCT）测量的视网膜厚度和视力。设计：横断面和纵向研究。参与者：210例患者（251只眼）DME患者参加了激光技术的随机临床试验。视网膜厚度用OCT测量，视力用糖尿病视网膜病变早期治疗电子程序测量。主要结果测量。光学相干断层扫描测量中心点厚度和visual acuity.Results：视力与OCT中心点厚度的相关系数分别为0.52在基线和0.49，0.36，0.38在3.5，8和12个月后激光光凝。基线数据的最佳拟合线的斜率约为基线中心点厚度每减少100 μ m视力提高4.4个字母（95%置信区间，3.5 - 5.3），随访时无重要差异。大约三分之一的视力变化可以通过线性回归模型预测，该模型包括OCT中心点厚度、年龄、血红蛋白A1C和荧光素渗漏的严重程度。激光治疗后3.5个月视力变化与OCT中心点增厚变化之间的相关性为0.44，在其他随访时间无重要差异。一个子集的眼睛表现出矛盾的改善视力增加中心点增厚（3个时间点为7%-17%）或视敏度反常恶化伴中心点增厚减少（3个时间点为18%-26%）。结论：OCT测量的中心点厚度与视力之间存在适度的相关性，视网膜增厚的变化与局部激光治疗DME后的视力之间存在适度的相关性。然而，对于给定程度的视网膜水肿，可能会观察到大范围的视力。因此，尽管视网膜厚度的OCT测量代表了临床评价中的重要工具，但它们不能可靠地替代在给定时间点的视敏度。本研究未讨论OCT的短期变化是否可预测对视力的长期影响。
Objective: To compare optical coherence tomography (OCT)-measured retinal thickness and visual acuity in eyes with diabetic macular edema (DME) both before and after macular laser photocoagulation.Design: Cross-sectional and longitudinal study.Participants: Two hundred ten patients (251 eyes) with DME enrolled in a randomized clinical trial of laser techniques.Methods: Retinal thickness was measured with OCT and visual acuity was measured with the electronic Early Treatment of Diabetic Retinopathy procedure.Main Outcome Measures. Optical coherence tomography-measured center point thickness and visual acuity.Results: The correlation coefficients for visual acuity versus OCT center point thickness were 0.52 at baseline and 0.49, 0.36, and 0.38 at 3.5, 8, and 12 months after laser photocoagulation. The slope of the best fit line to the baseline data was approximately 4.4 letters (95% confidence interval, 3.5-5.3) of better of visual acuity for every 100-mu m decrease in center point thickness at baseline with no important difference at follow-up visits. Approximately one third of the variation in visual acuity could be predicted by a linear regression model that incorporated OCT center point thickness, age, hemoglobin A1C, and severity of fluorescein leakage. The correlation between change in visual acuity and change in OCT center point thickening 3.5 months after laser treatment was 0.44, with no important difference at the other follow-up times. A subset of eyes showed paradoxical improvements in visual acuity with increased center point thickening (7%-17% at the 3 time points) or paradoxical worsening of visual acuity with a decrease in center point thickening (18%-26% at the 3 time points).Conclusions: There is modest correlation between OCT-measured center point thickness and visual acuity, and modest correlation of changes in retinal thickening and visual acuity after focal laser treatment for DME. However, a wide range of visual acuity may be observed for a given degree of retinal edema. Thus, although OCT measurements of retinal thickness represent an important tool in clinical evaluation, they cannot substitute reliably as a surrogate for visual acuity at a given point in time. This study does not address whether short-term changes on OCT are predictive of long-term effects on visual acuity.