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Subclinical macular edema as a predictor of progression to CSME

Session Details

Session Title: Vascular Diseases II

Session Date/Time: Friday 27/09/2013 | 11:00-12:30

Paper Time: 12:04

Venue: Hall F (Level 2)

First Author: I.Pires PORTUGAL

Co Author(s):    A. Santos   S. Nunes   C. Lobo   J. Cunha-Vaz     

Abstract Details


Objective: To examine the relationship between subclinical diabetic macular edema (DME), as defined by Stratus central point thickness (CPT) and development of clinically significant macular edema (CSME) in nonproliferative diabetic retinopathy (NPDR).


1AIBILI, Coimbra, Portugal. 2 Centro Hospitalar e Universitário de Coimbra, Portugal


Research Design and Methods: A prospective, monocenter, observational study was designed to follow eyes/patients with diabetes type 2 and NPDR (ETDRS levels 20 and 35) with no prior laser treatment for two years or until development of CSME. 410 patients, one eye per patient, fulfilled the inclusion/exclusion criteria and were included in the study. Ophthalmologic examinations including BCVA, fundus photography and optical coherence tomography (OCT) were performed at baseline, six-month and at the last study visit (24-month or before laser treatment).


Results: 348 eyes/patients performed the 24-month visit or developed CSME. Of these 348 eyes/patients 26 developed CSME. Presence of subclinical DME was defined as a CPT at baseline between 225 and 299 ┬Ám. Thirty two eyes/patients presented with subclinical DME at baseline. Six of these 32 eyes/patients developed CSME. Eyes/patients with subclinical DME present a risk for DME progression 3.123 times higher than eyes/patients without subclinical DME (95%CI=1.221; 7.988). The presence of subclinical DME at baseline showed a positive predictive value for CSME development of 18.7% and a negative predictive value of 93.7%.


Conclusions: Subclinical DME identified by Stratus CPT predicts development of CSME in eyes with NPDR. The absence of subclinical DME indicates that these eyes are less likely to develop CSME in a two-year period.

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