Diagnostic Utility of Swept-Source OCT-Based Biometry and Fundus Photographs Compared to Spectral Domain OCT in Center-Involving Diabetic Macular Edema

ABSTRACT

Purpose

This study was aimed to evaluate the agreement between the swept-source optical coherence tomography (SS-OCT)-based biometry, fundus photographs, and their combination, in comparison to the gold standard spectral-domain optical coherence tomography (SD-OCT) for the detection of center-involving diabetic macular edema (CI-DME).

Methods

We conducted a retrospective cross-sectional study involving 55 subjects (78 eyes) diagnosed with diabetic macular edema (DME) detected clinically and on SD-OCT (Carl Zeiss Meditec AG). Post-mydriatic 45-degree color fundus photograph (Crystal-Vue NFC-700), 1 mm macular scan obtained from SS-OCT-based biometry (IOL-Master 700), and macula cube scan obtained from SD-OCT was used to detect and grade DME into CI-DME and NCI-DME.

Results

Our findings revealed that SS-OCT-based biometry was noted to have a high sensitivity of 1 (0.94–1.00) and a specificity of 0.63 (0.31–0.89) in detecting CI-DME compared to the gold standard (SD-OCT). When combined with data from fundus photographs, specificity decreased to 0.32 (0.15–0.53). Fundus photographs alone exhibited a low sensitivity of 0.52 (0.38–0.64) and a specificity of 0.45 (0.16–0.76) in CI-DME detection.

Conclusion

In conclusion, SS-OCT-based biometry can be used as an effective tool for the detection of CI-DME in diabetic patients undergoing cataract surgery and can serve as a screening tool in centers without SD-OCT facilities.

ABBREVIATIONS

Diabetic Macular Edema (DME); Center Involving Diabetic Macular Edema (CI-DME); Non-Center Involving Diabetic Macular Edema (NCI-DME); Swept-Source Optical Coherence Tomography (SS-OCT); Spectral-Domain Optical Coherence Tomography (SD-OCT); Anti-Vascular Endothelial Growth Factor (Anti-VEGF); Central Retinal Thickness (CRT); Intra Retinal Fluid (IRF); Sub Retinal Fluid (SRF); Diabetic Retinopathy (DR); Non Proliferative Diabetic Retinopathy (NPDR); Proliferative Diabetic Retinopathy (PDR); Best Corrected Visual Acuity (BCVA); Glycosylated hemoglobin (HbA1c); Mean Spherical Error (MSE); Standard Deviation (SD); Positive Predictive value (PPV); Predictive value (PPV); Negative predictive value (NPV); Area under the Curve (AUC)

KEYWORDS:

• Center-involving diabetic macular edema (CI-DME)
• fundus photographs
• spectral-domain –OCT (SD-OCT)
• swept-source-OCT (SS-OCT) based biometry

Acknowledgments

We would like to thank all the study participants for their support.

Author contribution statement

Conception and Design of the work- RR, CR and JJB

Data acquisition- SC, VN, RR, CR and JJB

Statistical analysis- JS

Interpretation of data- KR

Drafted the main manuscript- KR, SC, VN and AMP

All authors reviewed the manuscript

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data was obtained from a tertiary eye care hospital, and the patient data will be maintained with confidentiality. The data will be shared upon request and can be provided only after the approval from the institutional review board.

Additional information

Funding

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (or Ethics Committee) of Medical Research Foundation, [759-2019-P] and approved on (21-03-2019).