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C. Springer, F. Mackensen, U. Wiehler, P. Weimer, M. D. Becker, K. Rohrschneider; Microperimetry and Retinal Thickness in Chronic Uveitic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3900. doi: https://doi.org/.
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Aim of this study was to evaluate the correlation of retinal function and retinal morphology in uveitic macular edema during follow up of a controlled clinical study comparing systemic therapy with Interferon (IFN) Beta-1a for the treatment of intermediate uveitis with chronic macular edema to standard immunosuppressive therapy with methotrexate (MTX).
In this monocentric, randomized controlled clinical study 12 patients (mean age 44±12 years) with intermediate uveitis (3 patients with multiple sclerosis associated intermediate uveits and 9 patients with primary intermediate uveitis) and chronic macular edema received either IFN Beta-1a or MTX as systemic therapy. Outcome measures such as visual acuity (logMAR), retinal sensitivity (microperimetry) and retinal thickness (OCT) were determined at baseline visit and 2 consecutive follow-up examinations at 4 weeks and 3 months. Retinal sensitivity was determined in the central 10 degrees visual field employing the Micro Perimeter 1 (Nidek Inc.) while corresponding retinal thickness (central 3 mm) was measured using the Stratus OCT.
Up to now 10 patients reached the 3 months follow-up. Mean retinal sensitivity in the central 10 degrees visual field showed a slight amelioration from 14.9±4.4dB at baseline to 15.6±3.7dB at 3 months. Lowest sensitivity values were found in the foveal region (10.9±7.3dB at baseline, 13.7±4.4dB at 3 months), whereas the temporal (16.3±3.8dB at baseline) and superior region (16.6±3.1dB at 3 months) indicated the highest values. Mean retinal thickness in the central 10 degrees diminished from 395±91µm to 344±111µm at 3 months. While for retinal sensitivity no significant difference could be found between the IFN- and MTX-group (mean difference at baseline 1.2dB and 0.2dB at 3 months), retinal thickness increased in the MTX group (mean difference MTX minus IFN at baseline 29µm and 164µm at 3 months). Visual acuity improved more in the IFN-group than in the MTX-group and correlated well to foveal sensitivity while no correlation with foveal thickness could be found.
Microperimetry and OCT showed to be useful in the evaluation and follow-up of patients with uveitic macular edema. The results show, that morphologic change is not always correlated with an equivalent change in retinal function. Microperimetry enables a more precise analysis of retinal function than isolated visual acuity testing. Both techniques allow effective evaluation of therapeutic strategies in patients suffering from uveitic macular edema in addition to standard clinical examination.
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