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[A comparative study of various diagnostic procedures in macular edema]
Bei Tian1, Xiao-xin Li, Ming-wei Zhao
1Department of Ophthalmology, Peking University People's Hospital, Beijing 100044, China.
Objective:
To compare the results for diagnosis of macular edema between Heidelberg retina tomography (HRT-II macular edema module) and optical coherence tomography (OCT).
Methods:
Two hundred and twelve eyes of 106 macular edema patients were diagnosed with fundus fluorescein angiography (FFA). HRT-II was used to obtain Edema Index and OCT was used to measure the retina thickness in the fovea. The results were compared with FFA.
Results:
As FFA for gold standard, we compared with other diagnosis method. With regard to the diagnosis of macular edema by OCT, the Kappa value was 0.553, the odds ratio (OR) was 8.519. The Kappa value of HRT-II was 0.403 and OR was 3.210. In two groups of patients with and without macular edema, which were diagnosed by FFA, the difference of Macular edema Index P assayed by HRT-II between these two groups was significant (P = 0.00); while the difference of fovea retina thickness P assayed by OCT between these two groups was significant, too (P = 0.00). The best critical value of E was 2.00 and the ROC curve's area was 0.673 in the detection of macular edema by HRT-II. The best critical value of retina thickness for the diagnosis of macular edema was 170 microm and the ROC curve's area was 0.774 in the detection of macular edema by OCT.
Conclusions:
In regard to the diagnosis of macular edema, the sensitivity of HRT-II is better than that from OCT, with a lower false-negative result. However, HRT-II has a relatively low specialty with a higher false- positive result. As for the localization of macular edema, HRT-II has its advantage. Compared with FFA, the consistence of OCT for the diagnosis of macular edema is better than that of HRT-II. We can conclude from the OR value that OCT has greater influence than HRT-II in the diagnosis of macular edema. In addition, as for the diagnosis and different diagnosis, the clinical value of OCT is higher than that of HRT-II. Combination of these two different diagnostic methods might provide an accurate quantitative analysis of macular edema.