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1 From the Department of Ophthalmology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark; and the 2 Eye Clinic, Steno Diabetes Center, Gentofte, Denmark.
PURPOSE. To compare retinal thickening in diabetic macular edema assessed subjectively by evaluation of stereo fundus photographs with that assessed objectively by optical coherence tomography (OCT).
METHODS. Forty-degree stereo fundus photographs of the macular field and OCT
scans in 84 eyes of 47 patients with diabetes were compared in terms of
both location and area of retinal thickening. Six radiating 6-mm OCT
scans at intervals of 30° were obtained, and the retinal thickness
was compared with the mean retinal thickness ± 2 SD of healthy
control subjects (33 eyes). Subsequently, retinal thickness was mapped
topographically and the subjectively assessed retinal thickening map
was overlaid. The degree of agreement on location was evaluated as
retinal thickening present or absent in nine subfields of the fundus.
Area of retinal thickening was divided into four categories: no retinal
thickening, less than 1 disc area (DA), less than 2 DAs, or less than 3
DAs, expressed as the 
statistic.
RESULTS. Exact agreement on location was found in 676 of 756 (84 x 9)
observations (89.4%; = 0.69; 95% confidence interval [CI]:
0.63–0.75). Two eyes in which both methods assessed the same amount of
retinal thickening showed no agreement on location. These eyes were
compared only in terms of location. Exact agreement on area was found
in 69 (84.1%) of 82 eyes. Weighted (w) = 0.79;
95% CI: 0.76–0.82).
CONCLUSIONS. The degree of agreement between subjectively and objectively assessed retinal thickening was very good, implying that changes in diabetic macular edema can be accurately and prospectively measured with OCT.
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