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      Macular thickness measurement in clinically significant macular edema before and after meal

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          Abstract

          Purpose

          To evaluate the macular thickness changes in diabetic macular edema after meal.

          Methods

          In this prospective case series, macular thicknesses of diabetic patients with clinically significant macular edema (CSME) were measured after 7 h of fasting and repeated 2 h after breakfast.

          Results

          Thirty six eyes of 20 diabetic patients were evaluated. The mean central subfield thickness (CST) and maximum retinal thickness (MRT) significantly decreased after meal (mean change of −10.3 ± 14.3 μm and −13.1 ± 12.7 μm, respectively, both P < 0.001). A decrease in CST and MRT values was found in 23 (63.8%) and 28 (77.7%) eyes, respectively, and no eye had an increase in retinal thickness measurements. Significant correlation was found between CST and MRT change and fasting thickness measurements (P = 0.001 and P = 0.01, respectively) and intraretinal cystic spaces (P = 0.001 and P = 0.03, respectively). Mean MRT change was significantly higher in the presence of subretinal fluid (P = 0.01).

          Conclusion

          Retinal thickness measurements may change after meal. So, fasting state of diabetic patient should be considered in measurement of macular thickness of patients with CSME.

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          Most cited references22

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          Optical coherence tomography--current and future applications.

          Optical coherence tomography (OCT) has revolutionized the clinical practice of ophthalmology. It is a noninvasive imaging technique that provides high-resolution, cross-sectional images of the retina, retinal nerve fiber layer and the optic nerve head. This review discusses the present applications of the commercially available spectral-domain OCT (SD-OCT) systems in the diagnosis and management of retinal diseases, with particular emphasis on choroidal imaging. Future directions of OCT technology and their potential clinical uses are discussed. Analysis of the choroidal thickness in healthy eyes and disease states such as age-related macular degeneration, central serous chorioretinopathy, diabetic retinopathy and inherited retinal dystrophies has been successfully achieved using SD-OCT devices with software improvements. Future OCT innovations such as longer-wavelength OCT systems including the swept-source technology, along with Doppler OCT and en-face imaging, may improve the detection of subtle microstructural changes in chorioretinal diseases by improving imaging of the choroid. Advances in OCT technology provide for better understanding of pathogenesis, improved monitoring of progression and assistance in quantifying response to treatment modalities in diseases of the posterior segment of the eye. Further improvements in both hardware and software technologies should further advance the clinician's ability to assess and manage chorioretinal diseases.
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            Comparison of macular thickness measurements between time domain and spectral domain optical coherence tomography.

            To compare macular thickness measurements obtained from time domain optical coherence tomography (OCT) and spectral domain OCT and to evaluate their repeatability and agreement. Thirty-five healthy normal subjects were included. In one randomly selected eye in each subject, three serial macular measurements were obtained from a time domain OCT (Stratus OCT, Carl Zeiss Meditec, Dublin, CA) and a spectral domain OCT (3D OCT; Topcon, Tokyo, Japan) by an experienced technician in random order. Total and regional macular thicknesses obtained by the two OCTs were compared. Their agreement was examined with Bland-Altman plots. Repeatability (2.77 x within subject SD [Sw]), coefficient of variation (CVw; Sw/overall mean), and intraclass correlation coefficient (ICC) were calculated to evaluate repeatability. Low variability for macular thickness measurements was found in both time domain and spectral domain OCTs. The range of the respective CVw and ICC values were 1.6% to 3.2% and 0.85 to 0.91 for Stratus OCT and 0.6% to 2.4% and 0.92 to 0.99 for 3D OCT. 3D OCT demonstrated better repeatability for total and regional macular thicknesses (all with P
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              Assessment of artifacts and reproducibility across spectral- and time-domain optical coherence tomography devices.

              To report the frequency of optical coherence tomography (OCT) scan artifacts and to compare macular thickness measurements, interscan reproducibility, and interdevice agreeability across 3 spectral-domain (SD) OCT (also known as Fourier domain; Cirrus HD-OCT, RTVue-100, and Topcon 3D-OCT 1000) devices and 1 time-domain (TD) OCT (Stratus OCT) device. Prospective, noncomparative, noninterventional case series. Fifty-two patients seen at the New England Eye Center, Tufts Medical Center Retina Service, between February and August 2008. Two scans were performed for each of the SD OCT protocols: Cirrus macular cube 512 x 128 (software version 3.0; Carl Zeiss Meditec, Inc., Dublin, CA), RTVue (E)MM5 and MM6 (software version 3.5; Optovue, Inc., Fremont, CA), Topcon 3D Macular and Radial (software version 2.12; Topcon, Inc., Paramus, NJ), in addition to 1 TD OCT scan via Stratus macular thickness protocol (software version 4.0; Carl Zeiss Meditec, Inc.). Scans were inspected for 6 types of OCT scan artifacts and were analyzed. Interscan reproducibility and interdevice agreeability were assessed by intraclass correlation coefficients (ICCs) and Bland-Altman plots, respectively. Optical coherence tomography image artifacts, macular thickness, reproducibility, and agreeability. Time-domain OCT scans contained a significantly higher percentage of clinically significant improper central foveal thickness (IFT) after manual correction (11-mum change or more) compared with SD OCT scans. Cirrus HD-OCT had a significantly lower percentage of clinically significant IFT (11.1%) compared with the other SD OCT devices (Topcon 3D, 20.4%; Topcon Radial, 29.6%; RTVue (E)MM5, 42.6%; RTVue MM6, 24.1%; P = 0.001). All 3 SD OCT devices had central foveal subfield thicknesses that were significantly more than that of TD OCT after manual correction (P<0.0001). All 3 SD OCT devices demonstrated a high degree of reproducibility in the central foveal region (ICCs, 0.92-0.97). Bland-Altman plots showed low agreeability between TD and SD OCT scans. Out of all OCT devices analyzed, cirrus HD-OCT scans exhibited the lowest occurrence of any artifacts (68.5%), IFT (40.7%), and clinically significant IFT (11.1%), whereas Stratus OCT scans exhibited the highest occurrence of clinically significant IFT. Further work on improving segmentation algorithm to decrease artifacts is warranted.
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                Author and article information

                Contributors
                Journal
                J Curr Ophthalmol
                J Curr Ophthalmol
                Journal of Current Ophthalmology
                Elsevier
                2452-2325
                01 February 2016
                Sep-Dec 2015
                01 February 2016
                : 27
                : 3-4
                : 125-128
                Affiliations
                [1]Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
                Author notes
                []Eye research Center, Rassoul Akram hospital, Sattarkhan - Niayesh Street, Tehran 14456-13131, Iran. Tel: +989125394802; fax: +982166509162. Joobin.khadamy@ 123456gmail.com
                Article
                S2452-2325(15)30018-4
                10.1016/j.joco.2015.11.005
                4881225
                27239590
                3c0b8c62-aaff-47c7-8b64-1b79f5d22234
                Copyright © 2015, Iranian Society of Ophthalmology. Production and hosting by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 9 October 2015
                : 15 November 2015
                : 28 November 2015
                Categories
                Article

                diabetic macular edema,retinal thickness,fasting,meal
                diabetic macular edema, retinal thickness, fasting, meal

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