Diabetic Macular Edema Diagnosis Varies by Test

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The prevalence of diabetic macular edema differs with diagnosis criteria.
The prevalence of diabetic macular edema differs with diagnosis criteria.

(HealthDay News) — Diabetic macular edema  is more often diagnosed using monocular fundus photography than optical coherence tomography central subfield thickness, according to a study published in JAMA Ophthalmology.

Yu T. Wang, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues compared diabetic macular edema (DME) prevalence from monocular fundus photography and optical coherence tomography (OCT) images in a retrospective cross-sectional study involving 246 eyes from 158 participants. 

The presence of DME was assessed using definitions from the Multi-Ethnic Study of Atherosclerosis (MESA) and the National Health and Nutrition Examination Survey (NHANES). Diabetic Retinopathy Clinical Research Network eligibility criteria thresholds of central subfield thickness (CST) were used to identify the presence of DME on OCT.

The researchers found that the prevalences of DME and clinically significant macular edema (CSME) were 61.4% and 48.5%, respectively, based on MESA definitions for monocular fundus photographs, which were greater than DME prevalence based on OCT (21.1%). Based on NHANES definitions, DME and CSME prevalences from monocular fundus photographs (28.5% and 21.0%, respectively) were similar to OCT prevalence (21.1%). 

For eyes without DME on OCT, 58.2% and 18.0% were diagnosed as having DME on monocular fundus photographs based on MESA and NHANES definitions, respectively.

"Caution is suggested when extrapolating prevalence of eyes that may benefit from anti-vascular endothelial growth factor therapy based on epidemiologic surveys using photographs to diagnose DME," the researchers wrote.

Several authors disclosed financial ties to the pharmaceutical and ophthalmic industries.

Reference

  1. Wang YT, Tadarati M, Wolfson Y, Bressler SB, Bressler NM. Comparison of Prevalence of Diabetic Macular Edema Based on Monocular Fundus Photography vs Optical Coherence Tomography. JAMA Ophthalmol. 2015;doi:10.1001/jamaophthalmol.2015.5332.
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