Cross sectional evaluation of clinically significant macular edema using the SAVE II protocol

Session Details

Session Title: Free Paper Session 23: Vascular Diseases & Diabetic Retinopathy VI

Session Date/Time: Sunday 10/09/2017 | 08:00-09:30

Paper Time: 09:00

Venue: Room 120

First Author: : M.Bolz AUSTRIA

Co Author(s): :    D. Podkowinski   E. Wimmer   A. Mursch-Edlmayr   M. Ring   N. Luft                 

Abstract Details

Purpose:

To describe and evaluate patients with clinically significant diabetic macular edema (CSME) according to the SAVE II protocol.

Setting:

Cross sectional case series at the department of Ophthalmology at the Kepler University Linz

Methods:

The SAVE protocol was introduced in order to categorize typical morphologic findings in patients with CSME. In order to improve the protocol patients with CSME were examined at the department of Ophthalmology at the Kepler University Clinic, Linz. All patients were included, regardless of prior treatment. Visual acuity testing was performed according to the ETDRS protocol (early treatment of diabetic retinopathy study). Cataract grade was documented with a Scheimpflug image. Optical coherence tomography (OCT) and fluorescence angiography (FA) were performed on the same day. All imaging data were evaluated by three readers according to an improved version of the SAVE grading protocol for CSME (SAVE II). As additional parameters the body mass index (BMI), systolic blood pressure and a blood sample was taken to investigate the following blood parameters: glucose, hBA1c, serum creatinine, triclycerides, cholesterol, low density lipoproteins and high density lipoproteins. Descriptive statistical analysis of the acquired data was performed focusing on characteristics of the SAVE edema types. Additionally, several findings were correlated. A single score intraclass correlation was performed for intergrader variability .

Results:

In total 77 eyes of 77 patients were included in the study. The mean age of the patients was 64.9 ±8.2 years. 2 eyes were classified as SAVE edema type 1, 19 eyes as SAVE edema type 2, 28 eyes as SAVE edema type 3 and 28 eyes as SAVE edema type 4. Single Score Intraclass Correlation for the inter-rater reliability was 0.61. Cataract level was distributed equally between the SAVE edema types without any statistically significant difference. Central retinal thickness was statistically not significant between groups. There was no statistically significant difference between the edema types and the laboratory parameters evaluated in the study. BMI and systolic blood pressure showed no correlation with the edema type. There was a statistically significant difference in EDTRS visual acuity between SAVE group 2 and 4 (p<0.001), and between group 3 and 4 (p<0.001) with lower visual acuity in the SAVE group 4.

Conclusions:

The SAVE II protocol categorizes all morphologic alteration typically found in patients with CSME. There was a significant correlation between the 4 defined edema types and visual acuity. Morphologic findings did not correlate with any of the evaluated blood parameters.

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