Optical Coherence Tomography in the Diagnosis and Management of Diabetic Macular Edema: Time-Domain Versus Spectral-Domain

Abstract

Optical coherence tomography (OCT) is an important imaging modality in the setting of diabetic macular edema (DME). Its use allows more precise evaluation of retinal pathology in DME, including retinal thickness and edema, vitreomacular interface abnormalities, subretinal fluid, and foveal microstructural changes. Additional advantages include its ability to quantitatively monitor response to treatment of DME by laser, intravitreal pharmacotherapies, and vitreoretinal surgery. OCT measurements are now used in all major clinical studies of DME treatment as critical endpoints. This article presents a review of both time-domain and spectral-domain OCT in the diagnosis and management of DME. The authors discuss the various parameters evaluated by the OCT systems and provide an evidence-based evaluation of their accuracy, significance, reliability, and limitations. As the capability of OCT continues to advance, it appears that its use will play an increasingly important role in the understanding, evaluation, and treatment of DME.

Optical coherence tomography (OCT) for detection of macular oedema in patients with diabetic retinopathy

“…Optical coherence tomography is increasingly used for detecting macular oedema in people with DR because OCT is an objective and reliable tool (DRCR Network 2007b). Furthermore, OCT allows a quantitative follow-up of the effects of treatment and has become a tool for routine management of macular oedema by ophthalmologists (Schimel 2011). …”

Degree of Decrease in Central Retinal Thickness Predicts Visual Acuity Response to Intravitreal Ranibizumab in Diabetic Macular Edema

“…In this work, we address the issue of identification and characterization of response to intravitreal ranibizumab in patients with DME, in an effort to identify characteristics that may be associated with different visual outcomes to intravitreal ranibizumab therapy [18,21,22,23,24]. …”

Spectral-Domain Optical Coherence Tomography for Macular Edema

“…The pathogenesis is not understood completely, but intraretinal fluid develops secondary to microaneurysm formation, increased vascular permeability, and breakdown of the blood-retinal barrier [5, 16] (Figure 3). Vascular endothelial growth factor (VEGF) may play an important role [17].…”

“…With SD-OCT imaging, acquisition of 25,000 to 100,000 scans/second is routinely possible [5]. This is more than 100 times faster than the TD technique.…”