Metabolic Predictors and Diagnostic Performance of Fundus Autofluorescence for Diabetic Macular Edema: A Cross-Sectional Diagnostic Accuracy Study Using Swept-Source Optical Coherence Tomography as Reference Standard.

Authors

Ramzi Amin, Adrian Pratama, Abdul Karim Ansyori, Mohammad Aulia Molid Ogest Putra Calisanie

Published in

Diabetes, metabolic syndrome and obesity : targets and therapy. Volume 19. Pages 626077. Epub Sep 15, 2026.

Abstract

To evaluate the diagnostic performance of fundus autofluorescence (FAF) imaging for detecting diabetic macular edema (DME) using swept-source optical coherence tomography (SS-OCT) as the reference standard, and to identify metabolic factors associated with FAF detection accuracy in patients with type 2 diabetes mellitus.
This cross-sectional diagnostic accuracy study enrolled 120 eyes from 68 patients with type 2 diabetes mellitus at the Vitreoretina Subdivision, Department of Ophthalmology, RSUP Dr. Mohammad Hoesin, Palembang, Indonesia, between January 2024 and June 2025. All participants underwent comprehensive ophthalmic examination including FAF imaging and en face SS-OCT (DRI OCT Triton Plus, Topcon). Metabolic parameters including glycated hemoglobin (HbA1c), fasting lipid profile, body mass index (BMI), estimated glomerular filtration rate (eGFR), and diabetes duration were recorded. Diagnostic accuracy indices were calculated using 2×2 contingency tables. Multivariate logistic regression identified metabolic predictors of FAF detection concordance with SS-OCT.
DME was present in 78 eyes (65.0%) by SS-OCT. FAF demonstrated sensitivity of 73.1% (95% CI: 61.8-82.5%), specificity of 76.2% (95% CI: 61.5-87.2%), positive predictive value of 85.1%, negative predictive value of 60.4%, positive likelihood ratio of 3.07, negative likelihood ratio of 0.35, and diagnostic odds ratio of 8.68. HbA1c ≥8.5% (OR 3.42, 95% CI: 1.28-9.14, p=0.014), diabetes duration ≥10 years (OR 2.87, 95% CI: 1.15-7.16, p=0.024), and BMI ≥30 kg/m² (OR 2.31, 95% CI: 0.94-5.68, p=0.068) were independently associated with FAF-OCT concordance. Center-involved DME showed higher FAF sensitivity (82.4%) compared to non-center-involved DME (55.6%, p=0.012).
FAF imaging demonstrates moderate diagnostic accuracy for DME detection, with performance significantly influenced by metabolic status and DME subtype. Integration of metabolic risk stratification may optimize FAF-based screening in diabetic populations.

PMID:
42763671
Bibliographic data and abstract were imported from PubMed on 20 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.