The COMS Grading Scheme: Graded Features

Macular Angiographic Leakage
(Macular edema)

The wide-field photographic techniques used in the COMS rarely provide a stereoscopic image to determine retinal edema and thickening.  Surrogate markers are used.  Macular edema often causes mild opacification of the involved retina which appears slightly milky in comparison to the surrounding retina.  On angiography the retinal capillary bed is often abnormal with microaneurysms, areas of capillary non-perfusion, or diffusely dilated capillaries.  In the late frames of the angiogram, hyperfluorescence is seen in the macular region, often taking on a petalloid pattern, or a pattern of finely clustered circles. 

Severity

None: not present

Mild:  less than 1/2 disc area (standard photograph 1 with early and late angiograms) click on any image for higher resolution image click on your browser's "back" button to return to this page Stereo Pair (click on either image to see enlarged pair)

Moderate: more than 1/2 disc area, but less than 3 disc areas (standard photograph 2 with early and late angiograms) click on any image for higher resolution image click on your browser's "back" button to return to this page Stereo Pair

Severe: more than 3 disc areas

back to COMS index