VITRECTOMY IN THE CONTROL OF REFRACTORY UVEITIC CYSTOID MACULAR OEDEM

Abstract

Abstract: : Purpose: To evaluate the efficacy of vitrectomy in the treatment of refractory uveitic cystoid macular oedema. Methods: A retrospective nonrandomized comparative interventional study. The 43 vitrectomized eyes (37 patients, mean age 39.4) had a mean pre–vitrectomy follow up of 36.1 months and 29.5 months post–vitrectomy. This group was compared to 68 non–vitrectomized eyes (40 consecutive non–infective uveitic patients, mean age 39.7) with a mean follow up period of 69.4 months. Results: At first visit the mean logMAR VA was significantly better (p<0.0005) in the nonvitrectomized eyes (0.37 ± 0.54) than vitrectomized eyes (0.64 ± 0.38). Although this difference was narrowed at last visit, the mean logMAR VA was still significantly better (p = 0.009) in the nonvitrectomized (0.42 ± 0.56) than vitrectomized eyes (0.57 ± 0.63). For non–vitrectomized eyes, there was no significant change to mean LogMAR VA from first visit to last visit. For vitrectomized eyes with CME, the mean logMAR VA reduced significantly (p = 0.033) from first visit to the time of vitrectomy (0.80 ± 0.46) but improved significantly (p = 0.005) after vitrectomy. In the non–vitrectomized eyes the mean logMAR VA reduced insignificantly (p = 0.49) from first to last visit. Conclusions: The visual outcome was favourable in vitrectomised eyes. Vitrectomy is useful in the management of refractory cystoid macular oedema not responding to medical treatment.

Keywords: uveitis–clinical/animal model • vitreous • macula/fovea