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Breno Lima, Sankaranarayana Mahesh, H Nida Sen; Optical coherence tomography features in uveitic macular edema. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5842. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize features of macular edema using spectral-domain optical coherence tomography (OCT) in patients with uveitis in a tertiary referral clinic.
Retrospective, cross-sectional study of uveitis patients with macular edema imaged with spectral-domain OCT between September 2007 through May 2011. The first OCT scan of each patient (baseline) was used in the study. Measurements of central subfield thickness (CST), macular cube volume and presence/absence of epiretinal membrane were obtained for all eyes with macular edema. Pattern of edema was classified in four groups (diffuse; intraretinal cysts; subretinal fluid; and mixed pattern with both intraretinal cysts and subretinal fluid). Photoreceptor layer was classified as disrupted or intact. Information on visual acuity, etiology of uveitis and anatomic location (anterior, intermediate, posterior or panuveitis) was obtained and correlated with OCT findings.
A total of 86 uveitic eyes (66 patients) with macular edema were evaluated by OCT. Mean patient age was 46.42 years ± 19.01. Mean central subfield thickness (CST) was 389.3 μm ± 175.2. Most common pattern of edema was intraretinal cysts (46.51%), followed by a mixed pattern with both intraretinal cysts and subretinal fluid (36.05%). The mean logMAR visual acuity was 0.54 ± 0.34 (Snellen equivalent 20/69). Most prevalent anatomic location of uveitis was panuveitis (36.05%), followed by intermediate uveitis (24.42%). The etiology of uveitis was idiopathic in the majority of cases (50 eyes, 38 patients), followed by sarcoidosis (9 eyes, 7 patients). No pattern of edema was pathognomonic of a specific site of inflammation or etiology of uveitis. Linear regression analysis evaluating the relationship of logMAR visual acuity and CST showed a statistically significant positive correlation between poorer logMAR visual acuity and increased CST (r squared=0.121, p=0.001). Comparison of eyes with or without epiretinal membrane did not show a statistically significant difference in visual acuity (p=0.32). Eyes with disruption of the photoreceptor (PR) layer had worse visual acuities compared to eyes with intact PR layer (p=0.0002).
Macular edema may complicate the course of uveitis regardless of the anatomic location of inflammation or etiology. Certain architectural OCT features such as severe disruption of the photoreceptor layer are indicators of poor visual acuity.
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