Course of Uveitic Macular Edema. An Optical Coherence Tomography Study

Abstract

Abstract: : Purpose: To describe the course of uveitic macular edema using optical coherence tomography (OCT) and to explore possible correlation between tomographic features and visual acuity. Method: In a prospective study sixty consecutive uveitis patients with the diagnosis of uveitic macular edema in at least one eye underwent complete ophthalmic examination, and optical coherence tomography (OCT).Inclusion criteria for the study were: (1) Adequate media clarity. (2) Absence of ocular disease other than macular edema limiting visual potential. Patients received the indicated treatment and the ophthalmic examination and OCT was performed at the beginning of the study, monthly in the first 6 months and upon completion of 12 months. In cases of bilateral macular edema the worst eye, regarding its visual acuity, was used for statistical analysis.Results: Sixty patients (82 eyes) 30 male and 30 female, mean age 35.8 ± 16.20 years (range 8-73 years) were enrolled in our study. Two patients could not return for follow up. One patient was excluded from the study due to the development of advanced visually significant cataract.Seventy six eyes of fifty seven patients were analysed. Complete resolution of macular edema occurred in 40 eyes (52.63 %) partial resolution in 12 eyes (15.78 %) no improvement in 14 eyes (18.42%), whereas in 10 eyes (13.15%) there was a worsening of macular edema despite treatment efforts.Mean Snellen visual acuity was 5.53 ± 2.78 (range 1-10) upon study entry and 7.10 ± 2.74 (range 2-10) upon study completion. The difference was statistically significant (p=0.011). The corresponding mean retinal thickness at the central fovea was 333.02 ± 170.61 µm (range 128µm in cases with extrafoveal edema 769 µm) at the beginning of the study vs 256.84 ± 128.00 µm (range 120-540 µm) in 12 months with the difference being statistically significant (p=0.014).Statistical analysis has shown that age (p< 0.001), presence of significant anterior chamber inflammation (p=0.026) and macular thickness (p<0.001) are negatively correlated with visual acuity changes. The effect of various treatment regimens on visual acuity or macular thickness was not statistically significant (p=NS). Conclusion: This study demonstrates the overall favorable visual prognosis of uveitic macular edema. Decrease in macular thickness as this is measured by OCT is well correlated with improvement of visual acuity in patients with clear media.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, S • clinical (human) or epidemiologic studies: sys • inflammation