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Liza M Cohen, Debra A Goldstein, Amani A Fawzi; Structure-Function Relationships in Uveitic Cystoid Macular Edema: Using En Face Optical Coherence Tomography to Predict Vision. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6177.
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© ARVO (1962-2015); The Authors (2016-present)
Attempts to correlate quantitative measurements on optical coherence tomography (OCT) with visual outcome in patients with uveitis-associated cystoid macular edema (CME) have generally not been successful. Our purpose was to test the hypothesis that preserved retinal tissue on baseline en face OCT imaging correlates with post-treatment visual outcome in eyes with uveitic CME.
A retrospective observational cohort study was conducted on 25 eyes of 23 patients with uveitis and baseline en face OCT imaging (Cirrus high-definition OCT) demonstrating CME. Eyes were included if they had resolution of CME at post-treatment follow-up. Exclusion criteria were end-stage maculopathy, concurrent diagnoses associated with CME, and poor OCT scan quality. Baseline en face OCT images were analyzed to determine the proportion of pixels representing preserved retinal tissue within a grid centered on the fovea. Macular thickness and volume data were also obtained from baseline OCT scans. Best-corrected logMAR visual acuity both at baseline and post-treatment CME resolution were correlated with OCT variables.
The proportion of preserved retinal tissue on baseline en face OCT was strongly correlated with logMAR visual acuity at baseline (r = 0.61, p = 0.0014) as well as logMAR visual acuity after CME resolution (r = 0.73, p < 0.0001). In contrast, central subfield macular thickness and macular volume at baseline were only weakly correlated with post-treatment vision (r = 0.38, p = 0.058 and r = 0.39, p = 0.055).
Preserved retinal tissue on baseline en face OCT strongly correlates with post-treatment visual acuity outcome in patients with uveitis-associated CME, and is a better OCT indicator of future vision than baseline macular thickness or volume. This is the first objective parameter measurable on OCT that has been shown to correlate strongly with visual outcome after resolution of uveitic CME.
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