Morphologic and functional evaluations during development, resolution, and relapse of uveitis-associated cystoid macular edema.
Retina
; 33(8): 1673-83, 2013 Sep.
Article
en En
| MEDLINE
| ID: mdl-23584695
ABSTRACT
OBJECTIVES:
To describe progression and resolution of uveitis-associated cystoid macular edema (uvCME) using spectral-domain optical coherence tomography and find predictive factors for successful intravitreal triamcinolone acetonide (IVTA) therapy.METHODS:
Twenty-nine eyes with treatment-naive uvCME were examined before and at 5 scheduled visits within 3 months after intravitreal triamcinolone acetonide administration. Distribution, resolution, relapse, and development of uvCME were evaluated using spectral-domain optical coherence tomography to describe morphology, progression, and relapse according to a standardized reading protocol. Applying repeated measures analysis of variance, morphologic findings were evaluated as predictive factors of the treatment outcome.RESULTS:
At baseline, 89.3% presented with focal CME; 65.6% had outer nuclear/Henley's layer and inner nuclear layer cysts. Following intravitreal triamcinolone acetonide administration, cysts of outer nuclear/Henley's layer diminished before those of inner nuclear layer (P = 0.0004). Small-pointed subretinal detachment (SRD) resolution synchronized with inner nuclear layer cyst extinction, whereas dome-shaped SRD resolution lagged behind (P = 0.014). Relapses of CME appeared in 71.4% of eyes with parafoveal inner nuclear layer cysts. Cysts of outer nuclear/Henley's layer were present in an additional 28.6%. None of the eyes developed SRD during CME relapse. The main effect variables "SRD" and "absence of epiretinal membrane" were associated with greater best-corrected visual acuity improvement (P = 0.05 and P = 0.047), whereas the side effect variables "CME duration", "age," and "uveitis location" had no additional effect on best-corrected visual acuity. Baseline SRD predicted a relapse-free clinical course within the observational period (P = 0.025).CONCLUSION:
Different morphologic patterns in uvCME may represent different stages in uvCME progression, and initial morphologic appearance can be linked to the clinical prognosis after the treatment.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Desprendimiento de Retina
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Triamcinolona Acetonida
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Uveítis Anterior
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Edema Macular
/
Membrana Epirretinal
/
Glucocorticoides
Tipo de estudio:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Retina
Año:
2013
Tipo del documento:
Article
País de afiliación:
Austria