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Sankaranarayana P. Mahesh, Amit Sangave, Theresa A. Larson, Wendy Smith, Robert B. Nussenblatt, H Nida Sen; Correlation Between Spectral Domain Optical Coherence Tomography And Fluorescein Angiography With Visual Acuity In Patients With Uveitic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4289.
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To evaluate the correlation between central foveal thickness as measured by spectral domain optical coherence tomography (SD-OCT) and visual acuity in patients with uveitic macular edema.
Patients followed for uveitis who had undergone SD-OCT and FA were included in this retrospective observational case series. FA and SD-OCT images were performed at the same visit and were analyzed for their relationship with visual acuity. A central macular thickness ≥275µm was considered as thickening. We also looked at the morphological features of the fovea for any correlation with visual acuity.
One hundred thirty one eyes (of 75 patients) were identified; 87 of the 131 eyes had macular edema as detected by SD-OCT (66.4%.). The mean retinal thickness was 321.4 (SD 130.9) microns and the mean logmar visual acuity was 0.24. Mean retinal volume was 10.7 cubic microns. Based on the SD-OCT morphology, four different patterns were recognized i) diffuse macular edema (n=34) ii) intraretinal cystic edema (n=41) iii) subretinal fluid (n=4) iv) both intraretinal cystic edema and subretinal fluid (n=12). FA detected macular edema in 76 of the 131 eyes (58%) and there was a concordance between FA and OCT in 87.5%. There was no strong correlation between visual acuity and SD-OCT or FA. Subgroup analysis showed that patients with intraretinal cystic edema and/or subretinal fluid presented with worse visual acuity (vision <20/50) as compared with eyes that had diffuse thickening (p<0.001). In addition, correlation was seen between eyes with photoreceptor layer damage on SD-OCT and worse initial visual acuity (vision <20/50) (p<0.001).
SD-OCT is a useful modality in evaluating retinal thickness as well as different structural patterns in patients with uveitic macular edema; however, it does not correlate well with visual acuity. In addition, identification of certain structural patterns such as cystoid edema, subretinal fluid or photoreceptor layer damage was associated with worse presenting visual acuity.
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