QUANTITATIVE ASSESSMENT OF MACULAR EDEMA WITH OPTICAL COHERENCE TOMOGRAPHY

Objective: To evaluate optical coherence tomography, a new technique f or high-resolution cross-sectional imaging of the retina, for quantita tive assessment of retinal thickness in patients with macular edema. D esign: Survey examination with optical coherence tomography of patient s with macular edema. Setting: Referral eye center. Patients: Forty-ni ne patients with the clinical diagnosis of diabetes or diabetic retino pathy and 25 patients with macular edema secondary to retinal vein occ lusion, uveitis, epiretinal membrane formation, or cataract extraction . Main Outcome Measures: Correlation of optical coherence tomograms wi th slit-lamp biomicroscopy, fluorescein angiography, and visual acuity . Results: Optical coherence tomograms of cystoid macular edema closel y corresponded to known histopathologic characteristics. Quantitative measurement of retinal thickness is possible because of the well-defin ed boundaries in optical reflectivity at the inner and outer margins o f the neurosensory retina. Serial optical coherence tomographic examin ations allowed tracking of both the longitudinal progression of macula r thickening and the resolution of macular edema after laser photocoag ulation. In patients with diabetic retinopathy, measurements of centra l macular thickness with optical coherence tomography correlated with visual acuity, and optical coherence tomography was more sensitive tha n slit-lamp biomicroscopy to small changes in retinal thickness. Concl usions: Optical coherence tomography appears useful for objectively mo nitoring retinal thickness with high resolution in patients with macul ar edema. It may eventually prove to be a sensitive diagnostic test fo r the early detection of macular thickening in patients with diabetic retinopathy.