Mantel A. E., Goebel W.

Department of Ophthalmology, Julius-Maximilians University, Würzburg, Germany

Objective: Objective and quantitative follow-up of macular edema with present clinical methods is limited. Fluorescein angiography shows presence of macular edema but gives only semiquantitative results and can not be repeated frequently as an invasive procedure. Therefore we studied to what extent optical coherence tomography may be clinically useful in diagnosis and follow-up of non-diabetic macular edema.
Methods: We evaluated 99 patients with non-diabetic macular edema retrospectively considering diagnosis, foveal retinal thickness in optical coherence tomography, fluorescein angiographic findings and visual acuity.
Results: In 53 of 55 cases (96%) the diagnosis of macular edema was confirmed by fluorescein angiography. Mean foveal retinal thickness was 401±166 µm considering all patients: In retinal vein occlusion 425±206 µm (36 eyes), Irvine-Gass 351±123 µm (17 eyes), macular pucker 374±129 µm (24 eyes) and uveitis 428±131µm (14 eyes). Mean visual acuity was 0,27. There was no definite correlation between visual acuity and foveal retinal thickness. Follow-up of 51 eyes showed a statistically significant decrease of foveal retinal thickness from 422 µm to 338 µm (p=0,0004) within an average of 21,1 days as well as a statistically significant improvement in visual acuity from 0,28 to 0,34 (p=0,03).
Conclusion: Optical coherence tomography can diagnose macular edema non-invasively and thus replace fluorescein angiography as invasive method. The reduction of macular edema in the course of therapeutic measures can be documented objectively with optical coherence tomography.

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