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Maria Elena Gonzalez-Montpetit, Sonia Valsero, Joseba Artaraz, Beatriz Jiménez Gómez, Ana Orive, Alex Fonollosa; Neuroretinitis: Clinical characterization and structural outcomes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):102.
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Neuroretinitis is an inflammatory disorder involving mainly the optic nerve. Macular edema and/or macular lipidic exudation accompanies optic nerve abnormalities, tipically presenting 10-15 days after the onset of symptoms. Prognosis is usually good in terms of visual acuity. Structural outcomes in terms of thickness of the macula and retinal nerve fiber layer have not been previously assessed. The aim of our study was to assess these structural outcomes in a cohort of patients from our Uveitis unit.
Retrospective review of clinical records. The following variables were recorded: age at onset, gender, etiology, treatment, initial and final visual acuity, presence of relative pupillary afferent defect , initial and final thickness of the macula and retinal nerve fiber layer (OCT) and type of macular edema. We assessed possible associations between final visual acuity and: 1. Etiology, 2. Type of macular edema 3. Initial macular thickness and 4. Initial retinal nerve fiber layer thickness. Statistics: Mann Whitney U, Wilcoxon and Pearson’s tests. Significance was set at p<0.05.
Twenty eyes of 15 patients (10 men, 5 women) were included. Mean age was 33.6 (18). Mean follow-up was 42 months. Seven cases (46,7%) were attributed to infection. Four eyes presented other types of signs: 2 retinal arteritis and macroaneurysms , 1 ischemic phlebitis with optic disk neovascularization and 1 frosted branch angiitis. Twelve patients (85.7%) received systemic treatment, being steroids the most frequent (50%). Five patients (33%) presented a relative pupil afferent defect. Mean initial and final visual acuity was 0.38 (0.3) and 0.62 (0.4) respectively, p=0.033. Mean initial and final retinal nerve fiber layer thickness was 241.09 (109) and 117.37 (100) respectively, p=0.015. Mean initial and final macular thickness was 394.92 (153) and 265 (75) respectively, p=0.05. We did not find any association between etiology, type of macular edema, initial macular thickness and initial retinal nerve fiber layer thickness and final visual acuity.
In our cohort of patients with neuroretinitis structural outcomes measured by OCT were good and paralleled the good functional outcomes in terms of visual acuity.
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