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Elysa A. Brown, Shree Kurup, Craig Greven, Andres Emanuelli, Sunir J. Garg, Nida Sen, Anita Agarwal, David Hinkle, Michael Samson, David Calannan; Prediction Of Visual Rehabilitation Based On Lesion Type, Size, and Location In Uveitic Disease. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1203.
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To assess whether a team of masked experts can prognosticate visual acuity based on chorioretinal or retinal lesion type, size, and location in posterior uveitis involving the macula as used in retinal non-uveitic disseases.
Retrospective review of data extracted from a Prognostication in Uveitis study data base. Pattern recognition of fundus lesions of ten patients, including OCT (time and space domain), angiography were presented. Experts were asked to predict visual acuity at onset and after therapy over a two year course.
There was a distinct bias towards a conservative estimation of the predicted therapeutic response without any relation to lesion type. VA at 6 months was underestimated by approximately 3 Snellen lines (0.27 LogMAR units (SD = 0.66)). At 12 months the VA was underestimated (0.24 LogMAR units (SD = 0.66) by approximately 2.5 Snellen lines. At two years the projected divergence between the evaluator curve and actual VA curve was even more pronounced.
It is difficult to prognosticate uveitis outcomes using typical retinal imaging studies and conventional methods as is used for medical retinal diseases. It should be attempted to capture sequelae of inflammatory aspects of the disease using newer imaging in sequential studies. Attention to the photoreceptors would be an option.
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