Detection of cystoid macular edema with three-dimensional optical coherence tomography versus fluorescein angiography

To compare the sensitivity and reproducibility of three-dimensional optical coherence tomography (3D-OCT) and fluorescein angiography (FA) for the detection of cystoid macular edema (CME).

Data were retrospectively collected from all patients who underwent digital FA and 512 × 128 horizontal raster 3D-OCT scans on the same day in a retina subspecialty clinic. Images were reviewed independently by four reading center graders and adjudicated as a group to render a single result for each eye and each imaging modality. The κ statistic was used to determine the level of agreement between graders for each modality. The sensitivity of each imaging modality for CME detection was calculated by using the presence of CME on either modality as the ground truth; subgroup analysis was performed according to disease diagnosis and lens status.

Four hundred thirteen eyes of 207 patients were included in the analysis. Intergrader agreement was higher for 3D-OCT than for FA both before (κ(OCT) = 0.61, κ(FA) = 0.43) and after adjudication (κ(OCT) = 0.74, κ(FA) = 0.58).The sensitivity for detection of definite CME was higher for 3D-OCT (95%, 144/151 cases) than for FA (44%, 67/151 cases). Definite FA (+) 3D-OCT (-) CME was identified in 1 eye (0.2%), whereas definite FA (-) 3D-OCT (+) CME was identified in 40 eyes (10%). No significant associations between CME detection and lens examination or disease diagnosis were observed.

In this study, 3D-OCT was more sensitive and had better intergrader agreement than did FA for the detection of CME.