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Raeba Mathew, Elizabeth Pearce, Sobha Sivaprasad, ; Qualitative and quantitative changes of cystoid macular edema treated with Ozurdex therapy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4898.
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To describe progression, resolution and relapse of cystoid macular edema (CME) over 9 months following Ozurdex therapy, to understand the prognostic values of various morphological features of CME.
Twenty-eight eyes with cystoid macular edema were examined at monthly intervals to assess the resolution and relapse of macular edema following Ozurdex therapy in a prospective study. The quantitative measures included central retinal thickness (CRT), central subfield thickness (CST), macular volume, number of zones with >300um, the foveal, parafoveal and perifoveal distribution of edema at monthly intervals. The qualitative measures included the presence, resolution and reappearance of cysts in different layers at each time points. Other structural changes included the persistence of foveal ellipsoid layer and external limiting membrane. Applying repeated-measures ANOVA, morphological findings were evaluated as predictive factors for relapse free period and treatment outcome.
At baseline, all patients presented with cystoid edema. 60.7% had both outer nuclear layer/Henle's-layer (ONL/HL), 21% had ONL cysts only and the rest had only inner nuclear layer (INL) cysts. Following Ozurdex therapy, ONL/HL-cysts diminished before INL-cysts (p=0.0008). Subretinal fluid disappeared in all cases by 3 months and recurrence in these cases were dominated by INL cysts. Subretinal fluid recurred in 31% of cases. SRD at baseline predicted a relapse-free clinical-course within the 9 months period (p=0.025).
Different morphologic patterns in CME resolve and relapse at different time-points and may represent different stages of disease progression.
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