Abstract
Purpose: :
To elucidate whether sub–clinical macular thickening is a feature of typical acute anterior uveitis (AAU).
Methods: :
Observational, prospective case series. Fifteen consecutive cases of typical, acute, unilateral, non–granulomatous AAU with best corrected visual acuity of 6/9 or worse were compared to twelve age matched controls. Optical coherence tomography (OCT) was performed within 7 days of onset. Macular thickness was compared between the affected and healthy eye of each patient.
Results: :
Fourteen out of 15 AAU patients were HLA B27–positive. Thirteen patients demonstrated sub–clinical macular thickening by OCT. Mean macular thickness asymmetry was 11.1% and 1.6% in patients and controls, respectively (p<0.0001). Mean macular volume asymmetry was 10% and 1% in patients and controls, respectively (p<0.0001). Thickness asymmetry as measured by OCT persisted beyond subjective and functional recovery, but largely resolved within 6 months.
Conclusions: :
Transient, diffuse, sub–clinical macular thickening is a previously–unrecognised but frequent phenomenon in acute anterior uveitis. It may play a role in the pathogenesis of transient visual impairment in such cases.
Keywords: uveitis-clinical/animal model • macula/fovea • inflammation