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C. C. Gottlieb, T. A. Larson, R. B. Nussenblatt, H. N. Sen; Autofluorescence Changes in Uveitic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2010;51(13):326.
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To investigate the presence, characteristics and progression of fundus autofluorescence (AF) changes over time in patients with uveitic macular edema.
Retrospective chart review performed at the National Eye institute of 19 patients with uveitic macular edema. Patients were identified by keyword search of the institute’s electronic medical record. Inclusion criteria were: presence of uveitic macular edema, Cirrus OCT central subfield thickness (CST) of greater than 250 microns (± 25 microns) and documented AF imaging. Baseline and follow-up data included best corrected visual acuity, OCT CST, photoreceptor layer morphology, duration of intraretinal fluid and area of autofluorescence change (mm2).
Seven patients (14 eyes) were included with a mean patient age of 39 years and a mean follow up time of 14 months. Uveitis types included intermediate (3), posterior (3) and panuveitis (1). Clinical diagnoses were idiopathic uveitis (5) and sarcoidosis (2). AF changes were found in 7 eyes (50%) of which 5 demonstrated hypoautofluorescent changes and 2 demonstrated hyperautofluorescence. The mean duration of intraretinal fluid was 10 months. In all eyes that had expansion of the AF area over time, the duration of intraretinal fluid was 12 months or more. The mean area of expansion was 1.4 mm2 over 10.1 months and linear regression analysis showed a relationship between duration of intraretinal fluid and AF change. The mean visual acuity decreased by logMAR 0.13 over the follow-up. Eyes with greater than 12 months of intraretinal fluid, AF changes and decreased visual acuity showed complete or partial absence of the photoreceptor layer (4 eyes).
Chronic intraretinal fluid is associated with AF changes in patients with uveitic macular edema. AF changes appeared after duration of 12 cumulative months of macular edema. Further study is required to determine whether AF changes are associated with decreased visual acuity or photoreceptor layer abnormalities.
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