Authors: Huo Yanjiao, Yang Lihong, Wei Wenbin
Cystoid macular edema (CME) is caused by many fundus diseases.The noninvasive clinical diagnosis methods for CME are conventional color fundus photography up to now.However, these images can not display the CME range well.Confocal scanning laser ophthalmoscope (cSLO) based retinal imaging can provide clear picture with high contrast.However, whether cSLO imaging is feasible in the quantitative assessment of CME remains unclear.
This study was to image the boundary of CME and assess the quantification of CME image from cSLO imaging technology.
A series case-observational study was designed.This study protocal was approved by Ethic Committee of Beijing Tongren Hospital.cSLO based retinal imaging technology was carried out on consecutive 24 eyes of 24 patients with clinically diagnosed and OCT confirmed CME in Beijing Tongren Eye Center from August to December 2015 under the informed consent of each individual.The radial scan range was 45°× 45° and the line scan level was 49 at macula area.The pseudocolar image, green light reflective image (532 nm) and infrared reflective image (785 nm) were collected.The imaging was analyzed by EasyScan software (version 1.2.2). Fundus color photography and SD-OCT were carried out in each patient.The images were graded by specialists according to the SD-OCT cross sectional results.
The primary causes of CME included epiretinal membrane (10 eyes), branch retinal vein occlusion (BRVO)(6 eyes), central retinal vein occlusion (CRVO)(4 eyes), diabetic retinopathy (DR)(3 eyes) and CRVO with BRVO (1 eye). A CME image was exhibited on the fundus color photogram with the obscure boundary; while the clear range of CME was displayed by the cSLO imaging.The mean score of CME from pseudocolar image, green light reflective image and infrared reflective image was 3.21±0.78, 2.67±0.96 and 2.54±0.83, respectively, which was significantly higher than 1.33±0.82 from the fundus color photography (all at P<0.01).
In CME patients, the imaging quality from cSLO-based retinal imaging technology is better than that from traditional fundus color photography.Combined with SD-OCT sectional scan analysis, cSLO-based retinal imaging technology may offer a method to observe and record more fundus details for CME diagnosis.