TY - JOUR
T1 - An optical coherence tomography-based grading of diabetic maculopathy proposed by an international expert panel
T2 - The European School for Advanced Studies in Ophthalmology classification
AU - Panozzo, Giacomo
AU - Cicinelli, Maria Vittoria
AU - Augustin, Albert J.
AU - Battaglia Parodi, Maurizio
AU - Cunha-Vaz, Josè
AU - Guarnaccia, Giuseppe
AU - Kodjikian, Laurent
AU - Jampol, Lee Merrill
AU - Jünemann, Anselm
AU - Lanzetta, Paolo
AU - Löwenstein, Anat
AU - Midena, Edoardo
AU - Navarro, Rafael
AU - Querques, Giuseppe
AU - Ricci, Federico
AU - Schmidt-Erfurth, Ursula
AU - da Silva, Rufino Martins
AU - Sivaprasad, Sobha
AU - Varano, Monica
AU - Virgili, Gianni
AU - Bandello, Francesco
N1 - Publisher Copyright:
© The Author(s) 2019.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Aims: To present an authoritative, universal, easy-to-use morphologic classification of diabetic maculopathy based on spectral domain optical coherence tomography. Methods: The first draft of the project was developed based on previously published classifications and a literature search regarding the spectral domain optical coherence tomography quantitative and qualitative features of diabetic maculopathy. This draft was sent to an international panel of retina experts for a first revision. The panel met at the European School for Advanced Studies in Ophthalmology headquarters in Lugano, Switzerland, and elaborated the final document. Results: Seven tomographic qualitative and quantitative features are taken into account and scored according to a grading protocol termed TCED-HFV, which includes foveal thickness (T), corresponding to either central subfoveal thickness or macular volume, intraretinal cysts (C), the ellipsoid zone (EZ) and/or external limiting membrane (ELM) status (E), presence of disorganization of the inner retinal layers (D), number of hyperreflective foci (H), subfoveal fluid (F), and vitreoretinal relationship (V). Four different stages of the disease, that is, early diabetic maculopathy, advanced diabetic maculopathy, severe diabetic maculopathy, and atrophic maculopathy, are based on the first four variables, namely the T, C, E, and D. The different stages reflect progressive severity of the disease. Conclusion: A novel grading system of diabetic maculopathy is hereby proposed. The classification is aimed at providing a simple, direct, objective tool to classify diabetic maculopathy (irrespective to the treatment status) even for non-retinal experts and can be used for therapeutic and prognostic purposes, as well as for correct evaluation and reproducibility of clinical investigations.
AB - Aims: To present an authoritative, universal, easy-to-use morphologic classification of diabetic maculopathy based on spectral domain optical coherence tomography. Methods: The first draft of the project was developed based on previously published classifications and a literature search regarding the spectral domain optical coherence tomography quantitative and qualitative features of diabetic maculopathy. This draft was sent to an international panel of retina experts for a first revision. The panel met at the European School for Advanced Studies in Ophthalmology headquarters in Lugano, Switzerland, and elaborated the final document. Results: Seven tomographic qualitative and quantitative features are taken into account and scored according to a grading protocol termed TCED-HFV, which includes foveal thickness (T), corresponding to either central subfoveal thickness or macular volume, intraretinal cysts (C), the ellipsoid zone (EZ) and/or external limiting membrane (ELM) status (E), presence of disorganization of the inner retinal layers (D), number of hyperreflective foci (H), subfoveal fluid (F), and vitreoretinal relationship (V). Four different stages of the disease, that is, early diabetic maculopathy, advanced diabetic maculopathy, severe diabetic maculopathy, and atrophic maculopathy, are based on the first four variables, namely the T, C, E, and D. The different stages reflect progressive severity of the disease. Conclusion: A novel grading system of diabetic maculopathy is hereby proposed. The classification is aimed at providing a simple, direct, objective tool to classify diabetic maculopathy (irrespective to the treatment status) even for non-retinal experts and can be used for therapeutic and prognostic purposes, as well as for correct evaluation and reproducibility of clinical investigations.
KW - Classification
KW - consensus
KW - diabetic macular edema
KW - diabetic maculopathy
KW - optical coherence tomography
KW - vitreomacular interface
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U2 - 10.1177/1120672119880394
DO - 10.1177/1120672119880394
M3 - Article
C2 - 31718271
AN - SCOPUS:85075131916
SN - 1120-6721
VL - 30
SP - 8
EP - 18
JO - European Journal of Ophthalmology
JF - European Journal of Ophthalmology
IS - 1
ER -