Abstract
Purpose: To assess the potential role of the Heidelberg Retina Tomograph (HRT) in screening for sight-threatening macular oedema in diabetes.
Methods One hundred and thirty-one eyes of 81 consecutive diabetic patients who fitted the inclusion criteria were included in the study. On HRT, the volume above the reference plane bound within a 2 mm diameter circle centred at the fovea was measured. The volumetric indices were compared with the mean measurement index in a group of 20 age-matched controls (mean score = 1, mean +2 SD score = 1.8). We also assessed the sensitivity of the subjective analysis of the intensity image and the addition of the three-dimensional map to the intensity image for detecting macular oedema and clinically significant macular oedema (CSMO).
Results One hundred and twelve eyes of 71 patients had a corrected Snellen visual acuity of 6/9 or better. When considering eyes with 6/9 or better vision only, the system's sensitivity for detecting CSMO was 58.33% ‘per eye’ examined, and 81.82% ‘per patient’ examined using a cut-off volumetric index of 1.8. In our study eyes with 6/9 or better vision, we found a 21% prevalence of CSMO. The predictive values of a positive test were 38.89% and 45% (cut-off score 1.8, ‘per eye’ and ‘per patient’ respectively) for CSMO. The predictive values of a negative test were 86.84% and 90.48% (cut-off score 1.8, ‘per eye’ and ‘per patient’ respectively) for CSMO.
Conclusions The volumetric assessment of diabetic maculopathy by HRT is a potentially useful method for screening eyes at risk. A larger group of patients with a greater number of eyes with minimal or no maculopathy is required to establish the specificity of this technique.
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Presented in part at the Second International Symposium for Macular Oedema in Lausanne, Switzerland, 23-25 April 1998
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Zambarakji, H., Butler, T. & Vernon, S. Assessment of the Heidelberg Retina Tomograph in the detection of sight-threatening diabetic maculopathy. Eye 13, 136–144 (1999). https://doi.org/10.1038/eye.1999.40
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DOI: https://doi.org/10.1038/eye.1999.40