Retinal thickness in diabetic retinopathy - Comparison of optical coherence tomography, the retinal thickness analyzer, and fundus photography

Background: Optical coherence tomography (OCT) and the retinal thickness analyzer (RTA) have proved their ability to measure retinal thickness in healthy subjects and diabetics reliably. In the present study, both techniques were compared for the same study population of diabetic patients, and the findings were related to macular edema shown by stereo fundus photography (SFP). Methods: Maculas of 124 eyes from 69 patients with diabetes mellitus were examined with OCT and the RTA. Measurements of retinal thickness were compared with signs of macular edema shown by SFP. For each eye, nine different sectors were analyzed (a foveal sector, four parafoveal sectors, and four extrafoveal sectors). Thirteen eyes with a normal macula served as controls. Sensitivity and specificity of detecting clinically significant macular edema (CSME) were calculated. Results: Of 111 eyes, 64 showed signs of CSME by SFP. Mean retinal thickness +/- SD of the foveal sector was 249 +/- 104 mu m by RTA and 295 124 mu m by OCT measurements. There was a moderate overall correlation between OCT and the RTA (r = 0.66). The correlation was best in the foveal sector (r = 0.82). Overall correlation with SFP was better for OCT (r = 0.77) than for the RTA (r = 0.62). Sensitivity of detecting CSME was consistently higher with OCT, while the RTA showed higher specificity. Conclusion: Both measuring techniques yielded similar results when examining eyes of patients with diabetes, although absolute values differed. OCT seems to be more suitable in the clinical screening for macular edema due to its high sensitivity (> 90%) with appropriate analysis parameters. The RTA is more prone to erroneous or missing thickness readings particularly under difficult measuring conditions.