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OCT imaging for macular edema moves beyond clinical management
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LAS VEGAS — Optical coherence tomography has many uses in the management of macular edema, a speaker said here.
Many characteristic features seen on OCT have prognostic significance, and based on some baseline OCT findings, patients can be told early what kind of treatment — laser, injection or surgery — to expect, Peter K. Kaiser, MD, said at the Optical Coherence Tomography and Imaging Panel Experts Review.
Peter K. Kaiser
In the past and in particular for diabetes, Kaiser said that a diagnosis of clinically significant macular edema was based solely on clinical exam; with OCT, however, that definition is changing.
“We can tell macular edema on OCT well before we can tell clinically that there’s clinically significant macular edema,” Kaiser said.
Fluorescein angiography remains important in imaging macular edema, particularly for patients with retinal vascular occlusion and diabetes, Kaiser said, because OCT is not yet able to discern macular ischemia. However, newer OCT devices will incorporate Doppler techniques to look at blood flow, he said. The problem is that fluorescein angiography does not correlate with vision or clinical outcome, he said.
“And it certainly doesn’t tell us anything about the vitreoretinal interface,” he said.
Among its uses in managing macular edema, OCT can be used to evaluate pathology of the disease by examining retinal thickness, cystoid macular edema, intraretinal fluid, subretinal fluid and vitreoretinal traction. It can also be used to monitor response to laser treatment, intravitreal pharmacotherapies and vitreoretinal surgery.
“My ‘go-to’ imaging device in all macular edema diseases is OCT,” Kaiser said.
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Disclosure: Kaiser is a consultant for and receives research grant and support from Carl Zeiss Meditec and Topcon.