Optimal optical coherence tomography-based measures in the diagnosis of clinically significant macular edema -: Retinal volume vs foveal thickness

Objective: To compare optical coherence tomography-based measures of retinal thickness and volume as quantitative tests for clinically significant macular edema (CSME). Design: Diagnostic validation study. Methods: Sixty-five eyes with diabetic retinopathy underwent stereo photographic and optical coherence tomographic examination. Stereo photographs were examined in a masked fashion to determine the presence or absence of CSME according to criteria from the Early Treatment Diabetic Retinopathy Study. Optical coherence tomography-based measurements of central foveal thickness as well as retinal volumes within a series of radii of fixation were generated. The main outcome measures were areas under receiver operating characteristic curves. Likelihood ratios, sensitivities, and specificities for the diagnosis of CSME were also evaluated. Results: Retinal volumes within radii of 0.50 mm and 1.11 mm of fixation and central foveal thickness were the best variables for discriminating between those with and without CSME as evidenced by analysis of receiver operating characteristic curves. There were no significant differences among these 3 variables in their performance as diagnostic tests for CSME. Conclusions: Optical coherence tomography-based retinal volume and central foveal thickness variables display comparable abilities to discriminate between those with and without CSME. Both measures may have clinical applications as quantitative diagnostic tests for CSME.