OCT offers insight, guidance on diabetic retinal diseases

WAILEA, Hawaii — Optical coherence tomography is a valuable tool for the clinician looking at a variety of diabetic retinal diseases and helps in evaluating underlying pathology, determining treatment, looking for possible surgical intervention and monitoring disease response, an expert said here.

Carmen A. Puliafito

"Spectral domain OCT offers us a very quantitative way of looking at clinically significant macular edema, to identify its geography very, very specifically in a comprehensive way, to monitor the results of treatment," Carmen A. Puliafito, MD, MBA, said at Retina 2009.

He explained that this evolving tool is the most effective way of imaging retinal thickness, cystoid macular edema, vitreoretinal traction and subretinal fluid, and then monitoring response to laser treatment, intravitreal pharmacotherapy and vitreoretinal therapy.

"It is the best way of determining whether or not the patient has a traction retinal detachment," Dr. Puliafito said. "In terms of surgical decision making, it is a very valuable tool."

He warned, though, that clinical wisdom must still be used judiciously.

"Never look at the OCT in isolation. Always correlate it to the clinical findings, to the fluorescein angiogram. That way you can make better clinical decisions because these algorithms fail. Even the best algorithms fail," he said.