Retina Service, Department of Ophthalmology, Bangkok Metropolitan Administration General Hospital, 514 Luang Rd, Pomprab District, Bangkok 10100, Thailand.
Br J Ophthalmol. 2010 Sep;94(9):1197-200. doi: 10.1136/bjo.2009.170589. Epub 2009 Dec 3.
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).
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.
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.
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.
比较频域光相干断层扫描（SD-OCT）和荧光素血管造影（FA）检测囊样黄斑水肿（CME）及其晚期并发症的能力。
回顾性、观察性、病例系列研究。纳入了 85 只眼，这些眼在首次就诊和/或随访时同一天进行了 FA 和 SD-OCT 检查。评估 FA 和 SD-OCT 图像中与 CME 及黄斑区其他结构改变相关的证据。然后将 FA 和 SD-OCT 图像叠加，以确定两种图像之间诊断特征的关系。主要观察指标是 CME 患者 FA 和 SD-OCT 黄斑结果之间的相关性。
本研究中 CME 的常见病因是视网膜静脉阻塞（RVO，63%）、糖尿病视网膜病变（DR，21.18%）和后葡萄膜炎（3.53%）。FA 漏诊了与 RVO、年龄相关性黄斑变性和 DR 相关的 CME 分别占 18.52%、33.33%和 33.33%。34.55%的 RVO 患者的视网膜下液在 FA 中无法检测到。SD-OCT 在 3 只眼（3.53%）中比 FA 更早地诊断出 CME。在 1 只眼（1.18%）中，FA 漏诊了随访时残留的 CME。长期 CME 的晚期并发症（两个眼继发黄斑裂孔、五个眼继发视网膜下液、一个眼视网膜色素上皮脱离和一个眼光感受器萎缩）仅可通过 SD-OCT 检测到。
SD-OCT 在检测 CME 方面比 FA 更敏感，尤其是那些与 RVO、DR 和年龄相关性黄斑变性相关的 CME。SD-OCT 也比 FA 更敏感，可检测到视网膜下液和长期 CME 的晚期并发症。
