Novel OCT prognostic indicators in diabetic macular oedema

Abstract

PurposeDespite advances in optical coherence tomography (OCT), clinicians have few prognostic indicators. We chose anomalous features found in OCTs, and retrospectively analysed OCT images for subsequent progression in visual acuity (VA), OCT results and interventions required over 22–24 months.MethodsPutative risk factors were grouped into sets based on similar putative aetiology: sub‐retinal fluid and large cysts, hyperreflective dots, partial/total disorganisation of retinal inner layers (DRIL) and photoreceptor disruption, epiretinal membranes, vitreomacular traction, vitreomacular adhesion. Eyes were stratified according to how many of these groups of features they displayed (0–4) and were all treated as per protocol and clinical need.ResultsIncreasing risk factors correlated with increasing initial OCT central retinal thickness (CRT) (387 vs. 555) and volume (9.99 vs. 11.28), and poorer initial visual acuity (0.41 vs. 0.60) on presentation.Whilst final CRT results showed no significant differences between the groups (325–248 nm), and no significant differences between numbers of injections performed (6.8 vs. 7.35), more features correlated with poorer VA, both absolute and relative to baseline, irrespective of whether there had been previous treatment.ConclusionsThese features are better prognostic indicators than OCT measurements alone.