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Akshay S Thomas, Travis Redd, J. Peter Campbell, Eric B Suhler, James T Rosenbaum, Phoebe Lin; The Impact and Implication of Peripheral Vascular Leakage on Ultra Widefield Fluorescein Angiography in Uveitis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1648. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To study if peripheral vascular leakage (PVL) on ultra-widefield fluorescein angiography (UWFA) is a prognosticator of complications of uveitis or necessitates treatment augmentation.
We performed a retrospective case-control study of all uveitis patients imaged with UWFA at our institution between November 2012 and January 2014. 73 eyes of 42 uveitis patients with UWFA at the initial visit and at least 1 year of follow-up were identified. Comparison of PVL and non-PVL groups for association with treatment augmentation, visual acuity (VA) change, and cystoid macular edema (CME) were done at baseline, intermediate and at final follow-up. Comparisons between the PVL and non-PVL groups and sub-group analyses were performed using bivariate analyses followed by multivariate logistic regression for dichotomous outcomes and multivariate linear regression for continuous outcomes.
There was no difference in the baseline, 6 month, or final visual acuity (p=0.26-0.95) or macular thickness (p=0.46-0.87) of patients with PVL vs. those without. Multivariate logistic regression showed no difference in risk of subsequent development of CME between the two groups (OR: 0.85, 95% CI: 0.11-6.77). A significantly greater proportion of patients with PVL received treatment augmentation than those without (66% vs. 38%, p=0.02) at baseline, but this association did not persist during future visits. Among patients with PVL, those with treatment augmentation at the baseline visit had similar VA and change in LogMAR VA at final follow-up compared to those without treatment augmentation.
Among patients with uveitis, PVL did not confer an increased risk of impaired visual acuity or macular edema either at baseline or up to at least 1 year later, although initial treatment augmentation may have masked an association with CME. Additionally, augmentation of treatment in patients with PVL without other signs of active disease appears to provide no additional benefit.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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