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Lazha Sharief, Yi-Hsing Chen, Susan Lightman, Oren Tomkins-Netzer; Prospective study of the morphologic and functional parameter changes post treatment of macular oedema associated with different retinal disorders. Invest. Ophthalmol. Vis. Sci. 2018;59(9):392.
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This study tested the hypothesis that retinal sensitivity (RS) can be a valuable indicator of retinal function in response to intravitreal steroid or anti-VEGF treatment in eyes with diabetic macular edema (DME), macular edema associated with retinal vein occlusion (RVO) or uveitis.
This prospective study included 68 patients (96 eyes) with macular edema (ME) secondary to diabetes mellitus (42 eyes), uveitis (36 eyes) or RVO (18 eyes). Nidek MP1 microperimetry was used to quantify retinal sensitivity using a total of 28 loci radiating from the fovea, including four loci dividing the central 0.6° and 12 loci used for each of the 1.2° and 2.5° radius circles. This was repeated at 3, 6, 12 and 24 months together with measuring the best corrected visual acuity (BCVA) and retinal thickness from optical coherence tomography scans
The overall median BCVA at baseline was 0.30 (IQR 0.18 – 0.30) LogMAR, with DME 0.30 (IQR 0.18 – 0.77), RVO 0.30 (IQR 0.18 – 0.48) LogMAR, and uveitis 0.30 (IQR 0.18 – 0.60) LogMAR (p= 0.81). The retinal average central subfield thickness (CST) was 401±156 μm, (DME 373± 121μm, RVO 448±190μm, and uveitis 408±171μm ; p=0.22). Central RS was 8.8 ±5.8 dB, including 8.4 ±5.9 dB in DME group, 7.8 ±5.3 dB in VO group, and 9.8 ±6.0 dB in uveitis group (p= 0.43). There was a significant negative correlation between the central RS and BCVA (r = -0.47, p<0.001), including DME (r = -0.42, p=0.006) and uveitis (r = -0.60, p<0.001), but not RVO cases (r = -0.37, p=0.12). Although at two years follow up the average CST was reduced from baseline (305 ±109 μm, p=<0.001), it was not associated with significant change in the RS. ME cases treated with intravitreal anti-VEFG showed significant improvement in central 1mm retinal thickness measured two years from baseline with a mean difference of 123μm, p=0.008 but no associated difference in BCVA (0.18 LogMAR, p= 0.13) or RS (median 7.7dB; p= 0.48).
The long term follow up of ME cases did not show a significant change in the RS following treatment even in the presence of reduced macular thickness at 2 years follow up from baseline.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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