Purpose: To compare conventional 30° spectral domain optical coherence tomography (SD-OCT) with 55° wide-field SD-OCT for the assessment of diabetic macular edema (DME). Methods: This study included 50 DME patients. Both 55° and 30° SD-OCT was conducted. Two readers evaluated scans according to a standardized grading protocol. Intergrader agreement as well as agreement between 30° and 55° SD-OCT were assessed. Results: Intergrader agreement (κ) was strong and ranged from 0.79 to 1.0. Perfect interdevice agreement (κ = 1.0) was found for the detection of intra- and subretinal fluid. Excellent agreement (κ ≥ 0.9) was found for the presence of epiretinal membrane (κ = 0.92) and cotton-wool spots (κ = 0.92). A strong agreement was found for the presence of hard exudates (κ = 0.89) and microaneurysms (κ = 0.81). A moderate correlation was found for ellipsoid zone integrity (κ = 0.69) and configuration of the vitreomacular interface (VMI) (κ = 0.69). A weak agreement was found for retinal pigment epithelium atrophy (κ = 0.51) and external limiting membrane integrity (κ = 0.35). Conclusion: Wide-field OCT imaging may be beneficial for evaluating DME, particularly for assessing the VMI and the integrity of hyperreflective bands.

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