April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Identifying a Clinically Meaningful Threshold for Change in Macular Edema in Patients with Uveitis
Author Affiliations & Notes
  • Jennifer E. Thorne
    Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, Maryland
  • Elizabeth Sugar
    Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland
  • Douglas A. Jabs
    Ophthalmology, Mount Sinai School of Medicine, New York, New York
  • Michael M. Altaweel
    Ophthalmology & Visual Science, Univ of Wisconsin-Madison, Madison, Wisconsin
  • Susan L. Lightman
    Ophthalmology, Moorfields Eye Hospital/Univ College London/Inst of Ophthalmology, London, United Kingdom
  • Nisha Acharya
    Ophthal-Proctor Foundation, Univ of California - SF, San Francisco, California
  • Albert T. Vitale
    Ophthalmology, Moran Eye Institute/University of Utah, Salt Lake City, Utah
  • MUST Research Group
    Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, Maryland
  • Footnotes
    Commercial Relationships  Jennifer E. Thorne, None; Elizabeth Sugar, None; Douglas A. Jabs, Abbott Laboratories, Alcon Laboratories, Allergan Pharmaceutical Corporation, Applied Genetic Technologies Corporation, Corcep, Genentech, Genzyme Corporation (C); Michael M. Altaweel, None; Susan L. Lightman, Bausch & Lomb, Immunocore, GlaxoSmithKline, Novartis Pharmaceuticals Corportation (C); Nisha Acharya, None; Albert T. Vitale, Bausch & Lomb, ACIONT Inc (C)
  • Footnotes
    Support  The Multicenter Uveitis Steroid Treatment (MUST) Trial Research Group is supported primarily by NEI Cooperative agreements: U10 EY 014655, U10 EY 014660, U10 EY 014656
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 4307. doi:
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      Jennifer E. Thorne, Elizabeth Sugar, Douglas A. Jabs, Michael M. Altaweel, Susan L. Lightman, Nisha Acharya, Albert T. Vitale, MUST Research Group; Identifying a Clinically Meaningful Threshold for Change in Macular Edema in Patients with Uveitis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4307.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : Optical coherence tomography (OCT) has become the gold standard for evaluating macular edema (ME). However, the threshold of change of retinal thickness (RT) that is clinically meaningful has yet to be identified. We sought to determine the threshold best able to predict clinically meaningful changes in visual acuity in the Multicenter Uveitis Steroid Treatment (MUST) Trial.

Methods: : RT was measured at the central subfield with time domain OCT and visual acuity (VA) was measured with logarithmic (ETDRS) visual acuity charts at enrollment and six months. Participants were classified as having ME if the RT was > 260µm. The association between percentage change in RT and clinically meaningful VA thresholds (>5 , >10 letters or ≥15 letters) was evaluated.

Results: : In the 75 eyes with ME at enrollment, a 20% improvement was optimal for predicting greater than 10-letter changes in visual acuity with a sensitivity of 75% and a specificity of 78%. Those with a 20% or greater reduction in retinal thickness had a mean 10.9 letter improvement (95% CI: 6.5 to 15.3) as compared to a -0.5 letter change (95% CI: -4.1 to 3.3) in visual acuity for those without a 20% reduction (p < 0.01).

Conclusions: : In addition to being above the level of measurement uncertainty, a 20% change in RT in patients with ME appears to be the optimal threshold for predicting clinically important changes in VA and may be considered as an outcome for clinical trials of treatments for uveitic macular edema.

Clinical Trial: : http://www.clinicaltrials.gov NCT00132691

Keywords: uveitis-clinical/animal model • clinical (human) or epidemiologic studies: systems/equipment/techniques • imaging/image analysis: clinical 

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