Investigative Ophthalmology & Visual Science Cover Image for Volume 65, Issue 9
July 2024
Volume 65, Issue 9
Open Access
ARVO Imaging in the Eye Conference Abstract  |   July 2024
Baseline characterization of DRIL in Uveitic Macular Edema
Justin Bitner; Brandon Vander Zee; Amitha Domalpally; Jeong W Pak; Rick Voland; Jennifer E. Thorne; Elizabeth Sugar; Janet Holbrook; Douglas A. Jabs; Michael Altaweel
Author Affiliations & Notes
  • Justin Bitner
    Wisconsin Reading Center, Department of Ophthalmology & Visual Sciences, University of Wisconsin System, Madison, Wisconsin, United States
  • Brandon Vander Zee
    Wisconsin Reading Center, Department of Ophthalmology & Visual Sciences, University of Wisconsin System, Madison, Wisconsin, United States
  • Amitha Domalpally
    Wisconsin Reading Center, Department of Ophthalmology & Visual Sciences, University of Wisconsin System, Madison, Wisconsin, United States
  • Jeong W Pak
    Wisconsin Reading Center, Department of Ophthalmology & Visual Sciences, University of Wisconsin System, Madison, Wisconsin, United States
  • Rick Voland
    Wisconsin Reading Center, Department of Ophthalmology & Visual Sciences, University of Wisconsin System, Madison, Wisconsin, United States
  • Jennifer E. Thorne
    Department of Epidemiology,, Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
    Wilmer Eye Institute, Department of Ophthalmology,, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Elizabeth Sugar
    Department of Epidemiology,, Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • Janet Holbrook
    Department of Epidemiology,, Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
  • Douglas A. Jabs
    Department of Epidemiology,, Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, Maryland, United States
    Wilmer Eye Institute, Department of Ophthalmology,, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Michael Altaweel
    Wisconsin Reading Center, Department of Ophthalmology & Visual Sciences, University of Wisconsin System, Madison, Wisconsin, United States
  • Footnotes
    Commercial Relationships   Justin Bitner, None; Brandon Vander Zee, None; Amitha Domalpally, None; Jeong Pak, None; Rick Voland, None; Jennifer Thorne, Canfield, Gilead, UptoDate; (C), NIE, ACTG; (F), Tarsier; Elizabeth Sugar, Holbrook grant (F); Janet Holbrook, None; Douglas Jabs, None; Michael Altaweel, national eye institute and Aura Biosciences (F), Opsis therapeutics (C)
  • Footnotes
    Support  Research to Prevent Blindness. In addition, this study is a multicenter clinic trial supported by collaborative agreements from the National Eye Institute, National Institutes of Health (Dr. Jabs U10EY024526, Dr. Holbrook U10EY024527, Dr. Altaweel U10EY024531). Allergan (Irvine, CA) donated a limited supply of dexamethasone implants for participants who could not obtain them otherwise.
Investigative Ophthalmology & Visual Science July 2024, Vol.65, PB00100. doi:
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      Justin Bitner, Brandon Vander Zee, Amitha Domalpally, Jeong W Pak, Rick Voland, Jennifer E. Thorne, Elizabeth Sugar, Janet Holbrook, Douglas A. Jabs, Michael Altaweel; Baseline characterization of DRIL in Uveitic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2024;65(9):PB00100.

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Abstract

Purpose : To identify disorganization of the retinal inner layers (DRIL) at baseline and its association with optical coherence tomography (OCT) imaging parameters among participants with uveitic macular edema from the PeriOcular vs. INTravitreal corticosteroids for uveitic macular edema (POINT) study

Methods : The POINT Trial compared the effectiveness of 3 regional corticosteroid injections for uveitic macular edema (UME). OCT scans were evaluated at baseline for the presence of DRIL within the central 1 mm circle and outside the 1 mm circle of the center B scan. Subjects with significant vitreomacular traction or severe epiretinal membranes were excluded. Central subfield thickness (CST), photoreceptor thickness, cysts, subretinal fluid, ellipsoid zone (EZ) status, and choroidal thickness were assessed at baseline.

Results : Of 231 eyes (190 participants), 191 eyes (83%) had DRIL at baseline. DRIL was seen within central 1mm in 182 eyes (79%). Mean CST at baseline differed significantly between eyes without and with DRIL; 376 um (SD 96) vs 500 um (SD 143), respectively (p < 0.001). Mean photoreceptor thickness was 31.7 um (SD 4.8) in eyes without DRIL and 28.9 um (SD 7.5) in eyes with DRIL (p = 0.015). In eyes without and with DRIL, EZ disruption within the Central subfield was found in 10.2% of eyes and 26.4%, respectively (p = 0.006). Mean choroidal thickness was 263 um (SD 82) in eyes without DRIL and 252 (SD 80) in eyes with DRIL (p = 0.412). Among other OCT features evaluated, DRIL was significantly associated with cystoid spaces (p< 0.001) but not with subretinal fluid (p = 0.462). Inter-grader agreement provided an 84% exact agreement for the presence of DRIL within the Central subfield.

Conclusions : In the POINT study, DRIL was prevalent in patients with uveitic macular edema at baseline, underlining its strong association with increased CST, cystoid spaces, photoreceptor thickness, and EZ disruption. The future analysis will follow DRIL longitudinally, as the edema subsides, to gain insights in understanding its prognostic value and implications for long-term treatment outcomes.

This abstract was presented at the 2024 ARVO Imaging in the Eye Conference, held in Seattle, WA, May 4, 2024.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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Copyright © 2025 Association for Research in Vision and Ophthalmology.
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