Elsevier

Ophthalmology

Volume 107, Issue 3, March 2000, Pages 593-599
Ophthalmology

Original Articles
Comparison between optical coherence tomography and fundus fluorescein angiography for the detection of cystoid macular edema in patients with uveitis☆

Presented in part at the Association for Research in Vision and Ophthalmology annual meeting, Fort Lauderdale, Florida, May 1998.
https://doi.org/10.1016/S0161-6420(99)00087-1Get rights and content

Abstract

Purpose

To compare optical coherence tomography (OCT) with fundus fluorescein angiography (FFA) for the detection of cystoid macular edema (CME) in patients with uveitis.

Design

Prospective comparative observational series.

Participants

One hundred twenty-one eyes of 58 patients with uveitis of varied causes (seven patients were studied twice).

Testing

Patients with suspected CME underwent OCT scanning followed by FFA at the same visit.

Main outcome measures

Detection and distribution of macular edema.

Results

One hundred eight eyes had similar results on both OCT and FFA in that 67 eyes had CME and 41 eyes had no CME. In 10 eyes subretinal fluid was detected on OCT but not FFA. Five of these eyes had CME on FFA but not OCT. Three other eyes had CME that was detected by FFA but not by OCT. Compared with FFA, the OCT sensitivity for detecting CME was 96% (including the eyes with subretinal fluid), and the OCT specificity was 100%.

Conclusions

OCT is as effective at detecting CME as is FFA but is superior in demonstrating axial distribution of fluid.

Section snippets

Patients and methods

Patients were recruited from the uveitis clinic at St. Thomas’ Hospital, London, between January 1997 and March 1998, after Institutional Review Board/Ethics Committee approval was obtained. One hundred twenty-one eyes of 58 patients were included. Thirty-one patients had idiopathic retinal vasculitis (IRV), seven had sarcoidosis, five had intermediate uveitis, four had Behçet’s disease, three had birdshot chorioretinopathy, three had Harada’s disease, and there was one patient each with

Results

A summary of the results is shown in Table 1. Sixty-seven eyes had CME on both FFA and OCT (Figure 2). Eight eyes had CME detected by FFA but no intraretinal spaces on OCT. Five of these had subretinal fluid (SRF) on OCT, and the other three eyes all had grade 1 CME. Five other eyes had SRF on OCT that was not detected by FFA. Forty-one eyes had no CME on FFA or OCT. Overall there was good agreement between the two tests (Kendall’s τ = 0.86 for intraretinal cysts and 0.78 for all fluid, P <

Discussion

Fluorescein angiography identifies breakdown of the blood-retinal barrier. Barrier breakdown precedes fluid-related thickening at focal sites, although previous studies have shown that thickening is not always present at these sites.9 Although fluorescein leakage indicates where thickening is likely to occur in the future and where thickening, if present, is likely to be detected, it does not give a measure of thickening itself. By contrast, OCT has the potential of measuring changes in retinal

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☆

Supported by the Lady Anne Allerton Fund and the Iris Fund for the Prevention of Blindness.

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Copyright © 2000 American Academy of Ophthalmology, Inc. Published by Elsevier Inc. All rights reserved.