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Dinah Zur, Shai Cohen, Matias Iglicki, Michaella Goldstein, Efrat Fleissig; Increase of Choroidal Thickness in Clinically Significant Pseudophakic Cystoid Edema. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4616.
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Inflammatory processes play a major role in the pathogenesis of pseudophakic cystoid macular edema (PCME). Choroidal thickness (CT) has been shown to be increased in non-infectious uveitis, using enhanced depth imaging optical coherence tomography (EDI-OCT). We performed a retrospective, observational clinical study to investigate the change in CT in eyes with PCME during the acute phase and following resolution of the edema.
Patients’ records were reviewed for cases of clinically significant PCME after phacoemulsification and implantation of an intraocular lens. Other previous ocular history or surgery, myopic refractive disorder exceeding -6.0 diopters, axial length >25.5 and difference in axial lengths between the eyes > 0.5mm were exclusion criteria. CT was measured using EDI-OCT (Spectralis; Heidelberg Engineering) beneath the fovea and on horizontal and vertical scans 1.5 mm nasal, temporal, inferior, and superior each from the center of the fovea. Measurements were taken at time of diagnosis of PCME in both eyes and again after resolution of edema in the affected eye.Statistic analysis was performed using paired T-test and Pearson Correlation.
Thirty-four eyes of 34 patients with clinically significant PCME were included (18 male, 16 female; mean age±SD, 76±9 years). Mean visual acuity±SD was 0.4±0.2 at time of PCME diagnosis and 0.7±0.2 after CME resolution (p<0.001). Mean subfoveal CT±SD for the affected eye was 258±83 microns at baseline and decreased to 215±79 microns (p<0.001). Mean subfoveal CT in the fellow eye measured 194±77 microns which was significantly lower than in the affected eye at baseline and after CME resolution (p<0.001and p=0.011, respectively). CT decreased significantly in all quadrants after CME resolution (p<0.01). Compared to the fellow eye, CT was higher in three quadrants at time of PCME (p<0.03) except for the inferior quadrant (p=0.08).
Choroidal thickness is increased in eyes with PCME and decreases following edema resolution. Anterior inflammation may directly affect choroidal thickness. These findings strengthen the hypothesis of an inflammatory pathogenesis in PCME.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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