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Thierry Zhou, Catherine P Garcher, Gilles Thuret, Alain M Bron, Florent Aptel, Pierre-Loic Cornut, Christophe Chiquet, ; Longitudinal study of retinal status using optical coherence tomography after acute post-cataract endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4176.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the macular status imaged by optical coherence tomography (OCT) in patients treated for acute post-cataract endophthalmitis.
Patients presenting with an acute post-cataract endophthalmitis were included in this multicenter study from January 2008 to December 2013. Exclusion criteria were traumatic or endogenous endophthalmitis, past history of macular disease and loss of follow-up. A Time Domain (TD) or a Spectral Domain (SD) OCT was performed at each visit.
46 patients with a follow-up at month 3, 6 and 12 were included in the OCT analysis. Bacterial identification was done in 67% of cases, and virulent bacteria were identified in 13%. The prevalence of epiretinal membrane (ERM) increased during the first year of 26% to 39%, that of vitreomacular traction (VMT) decreased from 12% to 6%, and that of non-traction macular edema (ME) varied between 6.5% and 13%. Incidence of macular atrophy remained stable at 10%. At month 12, a significant correlation was found between non-tractional ME and capsular rupture during cataract extraction (p=0.03). ERM was significantly associated with an increased central macular thickness (p=0.001) and a lower VA (Mean LogMAR: 0.4 ± 0.4 versus 0.12 ± 0.2, p=0.02) at M12 in comparison to the population with normal macula. OCT analysis showed a significant association between ERM and the alteration of the ellipsoid band (p=0.02), as well as the external limiting membrane (ELM, p=0.07) at M12.
ERM and ME are the main macular abnormalities diagnosed one year after management of acute post-cataract endophthalmitis. Final visual acuity ≥ 20/40 was obtained in 50% of these patients. Ultrastructural abnormalities of MLE and ellipsoid band were frequently noted.
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