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

Virgili, Gianni; Menchini, Francesca; Murro, Vittoria; Peluso, Emanuela; Rosa, Francesca; Casazza, Giovanni

doi:10.1002/14651858.cd008081.pub2

Cited by 91 publications

(90 citation statements)

References 59 publications

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“…Despite attempts to implement an OCT-based classification of DME [24] , there has been no consensus on its use. A Cochrane review concluded that there is substantial disagreement between the OCT findings and CSME as defined by clinical examination [25] . Nevertheless the changing treatment paradigm of DME, where anti-VEGF agents are increasingly being used in the management of DME, demonstrates that OCT is an essential tool in the current management of this condition [26] .…”

Section: Optical Coherence Tomography Classificationmentioning

confidence: 99%

Classification of diabetic retinopathy and diabetic macular edema

Wu¹

2013

WJD

350

231

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The global incidence and prevalence of diabetes mellitus (DM) have reached epidemic proportions. Estimates indicate that more than 360 million people will be affected by DM by 2030. All of these individuals will be at risk of developing diabetic retinopathy (DR). It is extremely important to categorize, classify and stage the severity of DR in order to establish adequate therapy. With proper management more than 90% of cases of visual loss can be prevented. The purpose of the current paper is to review the classification of DR with a special emphasis on the International Clinical Disease Severity Scale for DR.

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Section: Optical Coherence Tomography Classificationmentioning

confidence: 99%

Classification of diabetic retinopathy and diabetic macular edema

Wu¹

2013

WJD

350

231

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“…95 This applies to two studies of reticular pseudodrusen in AMD by Ueda-Arakawa and colleagues 97 and Smith and colleagues, 101 and to both studies of diabetic macular oedema, by Vusojevic and colleagues 98 and Waldstein and colleagues. 84 …”

Section: Summary Of Quality Assessment In Relation To Risks Of Biasmentioning

confidence: 95%

“…l Some studies included both eyes of patients in analyses, which (because of intrasubject correlations) may have led to underestimation of standard errors for sensitivity and specificity (and hence also underestimation of the width of the confidence intervals). 95 As there is no formally agreed approach for analysing such data in evidence syntheses, 95 the current review does not investigate their impact on the precision of diagnostic outcomes. However, such cases are clearly identified in the review and any inaccuracy of confidence intervals in these cases would not have markedly altered the review conclusions.…”

Section: Limitationsmentioning

confidence: 99%

Accuracy of fundus autofluorescence imaging for the diagnosis and monitoring of retinal conditions: a systematic review

Frampton

Kalita

Payne

et al. 2016

Health Technol Assess

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BackgroundNatural fluorescence in the eye may be increased or decreased by diseases that affect the retina. Imaging methods based on confocal scanning laser ophthalmoscopy (cSLO) can detect this ‘fundus autofluorescence’ (FAF) by illuminating the retina using a specific light ‘excitation wavelength’. FAF imaging could assist the diagnosis or monitoring of retinal conditions. However, the accuracy of the method for diagnosis or monitoring is unclear.ObjectiveTo conduct a systematic review to determine the accuracy of FAF imaging using cSLO for the diagnosis or monitoring of retinal conditions, including monitoring of response to therapy.Data sourcesElectronic bibliographic databases; scrutiny of reference lists of included studies and relevant systematic reviews; and searches of internet pages of relevant organisations, meetings and trial registries. Databases included MEDLINE, EMBASE, The Cochrane Library, Web of Science and the Medion database of diagnostic accuracy studies. Searches covered 1990 to November 2014 and were limited to the English language.Review methodsReferences were screened for relevance using prespecified inclusion criteria to capture a broad range of retinal conditions. Two reviewers assessed titles and abstracts independently. Full-text versions of relevant records were retrieved and screened by one reviewer and checked by a second. Data were extracted and critically appraised using the Quality Assessment of Diagnostic Accuracy Studies criteria (QUADAS) for assessing risk of bias in test accuracy studies by one reviewer and checked by a second. At all stages any reviewer disagreement was resolved through discussion or arbitration by a third reviewer.ResultsEight primary research studies have investigated the diagnostic accuracy of FAF imaging in retinal conditions: choroidal neovascularisation (one study), reticular pseudodrusen (three studies), cystoid macular oedema (two studies) and diabetic macular oedema (two studies). Sensitivity of FAF imaging using an excitation wavelength of 488 nm was generally high (range 81–100%), but was lower (55% and 32%) in two studies using longer excitation wavelengths (514 nm and 790 nm, respectively). Specificity ranged from 34% to 100%. However, owing to limitations of the data, none of the studies provide conclusive evidence of the diagnostic accuracy of FAF imaging.LimitationsNo studies on the accuracy of FAF imaging for monitoring the progression of retinal conditions or response to therapy were identified. Owing to study heterogeneity, pooling of diagnostic outcomes in meta-analysis was not conducted. All included studies had high risk of bias. In most studies the patient spectrum was not reflective of those who would present in clinical practice and no studies adequately reported how FAF images were interpreted.ConclusionsAlthough already in use in clinical practice, it is unclear whether or not FAF imaging is accurate, and whether or not it is applied and interpreted consistently for the diagnosis and/or monitoring of retinal conditions. Well-designed prospective primary research studies, which conform to the paradigm of diagnostic test accuracy assessment, are required to investigate the accuracy of FAF imaging in diagnosis and monitoring of inherited retinal dystrophies, early age-related macular degeneration, geographic atrophy and central serous chorioretinopathy.Study registrationThis study is registered as PROSPERO CRD42014014997.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…За счёт тракционных сил на участках устойчивого витреоретинального при-крепления, которые располагаются у диска зри-тельного нерва и в макуле, нередко развивается кистозный макулярный отёк. В некоторых слу-чаях тангенциальная тракция утолщённой натя-нутой задней гиалоидной мембраны индуцирует очень плоскую субклиническую макулярную от-слойку сетчатки, что сопровождается стойким снижением зрения [52,56].…”

Section: патогенез диабетического макулярного отёкаunclassified

Diabetic macular edema. Epidemiology, pathogenesis, diagnosis, clinical features, treatment

et al. 2015

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Обзоры ОАдрес для переписки: Raudi87@inbox.ru Распространение сахарного диабета (СД) приобрело в XXI веке характер неинфекционной эпидемии. По темпам прироста заболеваемости за последние 30 лет СД опередил такие инфек-ционные заболевания, как туберкулёз и инфек-цию, обусловленную вирусом иммунодефицита человека. Ещё 25 лет назад во всём мире насчи-тывали всего около 30 млн пациентов с СД. В течение последних лет темпы роста распростра-нённости заболевания неуклонно нарастают [7].Международная диабетическая федерация обнародовала новые данные о распространённос- Реферат В обзоре использованы материалы отечественных и зарубежных исследователей, проанализированы особен-ности спектральной оптической когерентной томографии у пациентов с сахарным диабетом и диабетическим макулярным отёком. Представлены современные данные о патогенезе, эпидемиологии, методах диагностики и лечения диабетического макулярного отёка. Сахарный диабет -одна из важных медико-социальных миро-вых проблем. Актуальность проблемы обусловлена масштабностью распространения сахарного диабета. Заболева-емость ежегодно увеличивается во всех странах, катастрофический рост числа заболевших принимает характер неинфекционной эпидемии. Одним из самых тяжёлых специфических поражений глаза при сахарном диабете считают диабетическую ретинопатию. Несмотря на значительные достижения и новые направления медикамен-тозного и хирургического лечения в течение последних лет oтёк макулярной области становится самой частой причиной снижения центральной остроты зрения при сахарном диабете. Наиболее распространённым и инфор-мативным методом диагностики диабетического макулярногo oтёкa служит оптическaя когерентнaя томогра-фия. Это неинвазивный и высокоточный метод исследования, с помощью которого стало возможным получать изображение поперечного среза исследуемых тканей in vivo, оценивать толщину сетчатки в микрометрах, объём в кубических миллиметрах, её структуру. Внедрение этого метода привело к революционным изменениям в диагнос -тике и лечении диабетической ретинопатии. Терапия диабетического макулярногo oтёкa требует компенсации комплекса биохимических и патофизиологических локальных и системных изменений, происходящих в глазу при сахарном диабете. В настоящее время методaми лечения диабетическoй ретинопатии являются лазерные и хирургические (витрэктомия) вмешательства, интравитреальное введение глюкокортикоидов и ингибиторов сосудистого эндотелиального фактора роста. Несмотря на достигнутые результаты в диагностике и лечении диа-бетического макулярного отёка эти вопросы требуют дальнейшего изучения.Ключевые слова: сахарный диабет, диабетический макулярный отёк, спектральная оптическая когерентная томография, изменения сетчатки, методы диагностики, лечение. DIABETIC MACULAR EDEMA. EPIDEMIOLOGY, PATHOGENESIS, DIAGNOSIS, CLINICAL FEATURES, TREATMENT A.N. Amirov, E.A. Abdulaeva, E.L. Minkhuzina Kazan State Medical Academy, Kazan, RussiaThe article reviews domestic and international publications addressing the features of spectral optic coherence tomography in patients wi...

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

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

Cited by 91 publications

References 59 publications

Classification of diabetic retinopathy and diabetic macular edema

Classification of diabetic retinopathy and diabetic macular edema

Accuracy of fundus autofluorescence imaging for the diagnosis and monitoring of retinal conditions: a systematic review

Diabetic macular edema. Epidemiology, pathogenesis, diagnosis, clinical features, treatment

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