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K. Ohta, Y. Yamamoto, S. Shu; Vitrectomy for Persistant Macular Edema Secondary to Uveitis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2711.
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Macular edema is one of severe cause of eyesight degradation in uveitis. We retrospectively reviewed the utility of pars plana vitrectomy (PPV) for persistent macular edema after systemical administration of corticosteroids for uveitis.
We performed vitrectomies on 11 patients (15 eyes, 11 women) with macular edema secondary to uveitis resistant to medical treatment. All eyes were followed for more than 6 months (average 42.8 months) after operation. The ages ranged from 44 to 78 years, average 65.2 years. The series was comprised of 8 eyes with sarcoidosis and 7 eyes of unknown etiology. We reviewed Snellen visual acuity (VA), complications of vitrectomy, inflammation after operation, and retinal thickness and macular form with optical coherence tomography (OCT).
Six months postoperatively, Snellen VA had improved by 2 lines or more in 8 eyes (53%). Except for 3 patients who continued medical treatment to calm down the inflammation in the other eye, oral corticosteroid therapy could be stopped postoperatively in all cases. Macular edema resolved in 13 eyes (87%), but increased retinal thickness was noted in those with slow to improve VA compared with unimpaired eyes.
PPV for macular edema secondary to uveitis effectively improved the VA and enabled patients to discontinue oral corticosteroid therapy. However, persistent retinal thickening remains postoperatively, which appears to limit the improvement in visual acuity.
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