Diagnosis value of shortwave autofluorescence for cystoid macular edema / 中华实验眼科杂志

ABSTRACT

Background Cystoid macular edema (CME) is a manifestation secondary to multiple fundus diseases and often leads to the decline of visual acuity.Optical coherence tomography (OCT) is a common diagnostic method for CME,but it can not reflect the metabolism information of retinal pigment epithelium (RPE).Shortwave autofluorescence (SW-AF)may find the abnormality of macula,but its clinical value remains to be confirmed.Objective This study was to investigate the value of SW-AF in the diagnosis of CME.Methods One hundred and eighty-nine eyes of 140 patients who have the relative diseases to CME or received intraocular surgery were included from May 2010 to August 2011 in Lihuili Hospital of Ningbo city.SW-AF,infrared autofluorescence (IRAF),fundus fluorescein angiography (FFA) and OCT were performed in all the eyes under the informed consent of each patient.The sensitivity,specificity and other indicators in diagnostic test of SW-AF for CME were evaluated and compared with OCT.Results SW-AF had certain accuracy in diagnosis of CME with the sensitivity 78.29％,specificity 96.67％,Youden index 0.75,positive predictive value 98.06％,negative predictive value 67.44％.The area under curve (AUC) of SW-AF for the diagnosis of CME was 0.875 with the 95％ confidence interval (CI) 0.823-0.926 (P＜0.001).Compared with OCT,the differences of SW-AF and IR-AF in the diagnosis for CME was statistically significant(x2 =22.53,91.35,both at P＜0.001),and agreement coefficients of diagnosis result between SW-AF、IR-AF or FFA and OCT were 0.67,0.12 and 0.85.Conclusions SW-AF can be used as a new rapid,non-invasive,ancillary technique in diagnosis of CME with certain accuracy,and the diagnostic agreement of SW-AF with OCT is lower than FFA but is higher than IR-AF.