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  • September 10, 2021
  • 2021 Abstracts

SAVE IIA: Extension of the grading protocol for clinically significant diabetic macular edema using optical coherence tomography angiography

Author: Dominika Podkowinski (Austria)

Co-authors: David Aiglstorfer, Haidar Khalil, Marina Casazza, Anna-Sophie Mursch-Edlmayr, Matthias Bolz

Purpose

The purpose of the study was to extend the well-established SAVE II protocol for clinically significant diabetic macular edema (CSME) using swept-source optical coherence tomography angiography imaging (SS-OCTA). OCTA metrics were evaluated for each SAVEII edema type respectively.

Setting/Venue

Patients with the diagnosis of diabetic macular edema (DME), who presented between 2018 and 2021 to the outpatient clinic at the Department of Ophthalmology, Kepler University Clinic Linz (Linz, Austria) were included in the prospective analysis, regardless of prior treatment.

Methods

Visual acuity testing was performed according to the Early Treatment of Diabetic Retinopathy Study (ETDRS) protocol. Optical coherence tomography (OCT), fluorescence angiography (FA) and SS-OCTA imaging (Plex Elite 9000, Zeiss Meditec) were performed. SS-OCTA imaging was performed with a 6 mm × 6 mm, 3 mm × 3 mm and 15mm x 9 mm field of view. OCT and FA imaging were evaluated according to the established SAVE II protocol by Bolz et al. FAZ size, vessel and perfusion density of the superficial and deep capillary plexus based on OCTA imaging were calculated for each SAVE II edema type respectively. Further the SAVEII grading was performed using solely OCT and SS-OCTA imaging by two blinded investigators (D.P., M.C.). Results were compared between the standard SAVEII protocol (OCT and FA imaging) and the SAVEIIA protocol (OCT and OCTA imaging).

Results

45 eyes of 45 patients were included in the study. We included 8 patients with SAVEII edema type one, 13 patients with edema type two, 14 patients with edema type three and 10 with edema type 4 using the SAVEII grading proctocol. Using the SAVEIIA protocol, based on OCTA imaging, the patients were graded the same as by the standard SAVEII protocol. There were no statistically significant differences for calculated OCTA metrics between the SAVEII edema types. Detailed results of the OCTA metrics for each SAVEII group will be presented at the conference.

Conlusions

The SAVE IIA grading protocol of CSME was extended using the image technology of OCTA. The novel imaging technique of OCTA is a valid tool for the grading protocol of SAVE II and may supersede the image technology of fluorescein angiography in the future, due to it's non invasive technology and high resolution.

Financial Disclosure

There was no financial support to conduct this study. None of the authors has a conflict of interest to declare.

Comments

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