Abstract
Purpose :
To evaluate a potential correlation between best corrected visual acuity (BCVA) and optical coherence tomography (OCT) anatomic and temporal features in macular edema (ME) due to noninfectious uveitis (NIU). This analysis builds on a prior analysis which showed moderate correlation between BCVA and central subfield thickness (CST).
Methods :
This post hoc analysis of uveitic eyes evaluated the relationship between BCVA and the presence of cystoid spaces, presence of subretinal fluid (SRF), and ellipsoid zone (EZ) integrity collected during two Phase 3, 24-week clinical trials. Correlation analyses evaluating baseline and change from baseline relationships were conducted. A longitudinal treatment-response analysis was created to model the temporal relationship between change in BCVA and CST. Early CST anatomic response, defined as a reduction in CST of 50 µm or greater at 4 weeks, was assessed for relationship to BCVA prognosis.
Results :
The analyzed data set included a total of 198 uveitic eyes. For EZ at baseline, mean BCVA progressively worsened with each EZ grade, trends which were not evident for cystoid space or SRF gradations. Eyes with normal EZ experienced greater 24-week change in BCVA than those with abnormal baseline EZ (11.9 vs 9.4 letters, p=0.006). In contrast, eyes without cystoid spaces and/or SRF with center-involvement at baseline showed less improvement (5.5 letters or 9.5 letters, respectively) improvement at 24 weeks, compared to those eyes with center-involvement (13.7 letters, P=0.012 or 17.2 letter, P<0.001, respectively). Longitudinal modeling in uveitic eyes showed a more rapid effect for CST than BCVA, with CST requiring approximately 3 weeks to reach over 90% of full response and BCVA requiring approximately 9 weeks to reach the same magnitude of response. Eyes that showed an early anatomical response, experienced a greater 24-week improvement in BCVA, compared to those without an early response (12.6 vs 4.9 letters, P=0.007 for difference).
Conclusions :
Important and clinically meaningful relationships exist between BCVA and OCT anatomic and temporal features in eyes with uveitic macular edema, with anatomic improvement preceding BCVA improvement.
This is a 2021 ARVO Annual Meeting abstract.