Optical Coherence Tomography Classification Systems for Diabetic Macular Edema and Their Associations With Visual...

Area of Science:

• Ophthalmology
• Medical Imaging
• Diabetology

Background:

• Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
• Optical coherence tomography (OCT) is crucial for DME detection and assessment.
• Existing OCT-based classification systems for DME require updates.

Purpose of the Study:

• To review recent spectral-domain OCT (SDOCT)-based DME classifications (past 5 years).
• To summarize OCT qualitative and quantitative parameters for disease severity, progression, and treatment outcomes.
• To discuss the need for a framework to validate biomarkers for DME treatment prognosis.

Main Methods:

• Review of recent literature on SDOCT-based DME classifications.
• Analysis of proposed OCT qualitative and quantitative parameters.
• Synthesis of data on prognostic value for visual outcomes and treatment response.

Main Results:

• Several OCT parameters (e.g., macular thickness, ellipsoid zone integrity) show prognostic value.
• Lack of consensus exists on reliable parameters for predicting treatment outcomes.
• A framework for biomarker validity is essential for DME prognosis.

Conclusions:

• SDOCT-based DME classifications are advancing, but standardization is lacking.
• Further research is needed to establish reliable OCT biomarkers for predicting treatment success in DME.
• Updating current diabetic retinal disease classifications is a recognized need.