TY - JOUR
T1 - Association Between Fluid Volume in Inner Nuclear Layer and Visual Acuity in Diabetic Macular Edema
AU - Tsuboi, Kotaro
AU - You, Qi Sheng
AU - Guo, Yukun
AU - Wang, Jie
AU - Flaxel, Christina J.
AU - Bailey, Steven T.
AU - Huang, David
AU - Jia, Yali
AU - Hwang, Thomas S.
N1 - Funding Information:
Funding/Support: This study was supported by the National Institutes of Health National Eye Institute (R01EY027833, R01EY024544, P30EY010572), William & Mary Greve Special Scholar Award, and unrestricted departmental funding from Research to Prevent Blindness (New York, NY). The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Funding Information:
Funding/Support: This study was supported by the National Institutes of Health National Eye Institute (R01EY027833, R01EY024544, P30EY010572), William & Mary Greve Special Scholar Award, and unrestricted departmental funding from Research to Prevent Blindness (New York, NY). The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Financial Disclosures: Oregon Health & Science University (OHSU) and Yali Jia, Steven T. Bailey, and David Huang have a financial interest in Optovue Inc. OHSU and Yali Jia also have financial interest in Optos Inc. These potential conflicts of interest have been reviewed and are managed by OHSU. Kotaro Tsuboi has a financial interest unrelated to the current manuscript from Alcon Japan Ltd, Santen Co, Ltd, Novartis Pharma KK, and Bayer. The other authors indicate no financial support or conflicts of interest. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/5
Y1 - 2022/5
N2 - PURPOSE: In diabetic macular edema (DME), the correlation between visual acuity (VA) and central subfield thickness (CST) is weak. We hypothesize that fluid volume (FV) in the inner nuclear layer (INL) may correlate more strongly with VA. DESIGN: Retrospective, cross-sectional study. METHODS: One eye each of diabetic patients with DME was included. We measured intraretinal fluid volume that was detected by automated fluid detection algorithm on 3- × 3-mm optical coherence tomography angiogram volume scans. The detected fluid was subdivided into inner FV, bounded by the INL, and outer FV, the fluid between the outer border of INL to the ellipsoid zone. RESULTS: We enrolled 125 patients with DME (60 women; mean age, 61 years). The mean detected inner FV was 0.013 mm3 in 109 eyes (87%). The mean detected outer FV was 0.042 mm3 in 124 eyes (99%). Univariate analysis demonstrated that the VA significantly correlated with the inner FV (P < .0001), whole macular FV (P = .010), and CST (P = .036). Multivariate analysis demonstrated that the inner FV was the only significant factor (β = −0.41, P = .004). These correlations were consistent when the treatment-naïve group (n = 33) and the eyes without previous laser treatments (n = 93) were analyzed separately. The area under the receiver operating characteristic curve of inner FV for VA of 20/32 or worse was significantly higher than that for CST (0.66 vs 0.54, P = .018). CONCLUSIONS: The inner FV has a stronger association with VA than other OCT biomarkers in DME and may be more clinically useful.
AB - PURPOSE: In diabetic macular edema (DME), the correlation between visual acuity (VA) and central subfield thickness (CST) is weak. We hypothesize that fluid volume (FV) in the inner nuclear layer (INL) may correlate more strongly with VA. DESIGN: Retrospective, cross-sectional study. METHODS: One eye each of diabetic patients with DME was included. We measured intraretinal fluid volume that was detected by automated fluid detection algorithm on 3- × 3-mm optical coherence tomography angiogram volume scans. The detected fluid was subdivided into inner FV, bounded by the INL, and outer FV, the fluid between the outer border of INL to the ellipsoid zone. RESULTS: We enrolled 125 patients with DME (60 women; mean age, 61 years). The mean detected inner FV was 0.013 mm3 in 109 eyes (87%). The mean detected outer FV was 0.042 mm3 in 124 eyes (99%). Univariate analysis demonstrated that the VA significantly correlated with the inner FV (P < .0001), whole macular FV (P = .010), and CST (P = .036). Multivariate analysis demonstrated that the inner FV was the only significant factor (β = −0.41, P = .004). These correlations were consistent when the treatment-naïve group (n = 33) and the eyes without previous laser treatments (n = 93) were analyzed separately. The area under the receiver operating characteristic curve of inner FV for VA of 20/32 or worse was significantly higher than that for CST (0.66 vs 0.54, P = .018). CONCLUSIONS: The inner FV has a stronger association with VA than other OCT biomarkers in DME and may be more clinically useful.
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U2 - 10.1016/j.ajo.2021.12.012
DO - 10.1016/j.ajo.2021.12.012
M3 - Article
C2 - 34942107
AN - SCOPUS:85123125349
SN - 0002-9394
VL - 237
SP - 164
EP - 172
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -