MORPHOLOGIC AND FUNCTIONAL EVALUATIONS DURING DEVELOPMENT, RESOLUTION, AND RELAPSE OF UVEITIS-ASSOCIATED CYSTOID MACULAR EDEMA
| Autor: | Christian Simader, Philipp Roberts, Florian Sulzbacher, Wolfgang Huf, Christopher G. Kiss, René Rückert, Matthias Bolz, Marion R. Munk |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Visual acuity Side effect Visual Acuity Triamcinolone Acetonide Macular Edema Recurrence Ophthalmology medicine Humans Cyst Prospective Studies Glucocorticoids Macular edema business.industry Retinal Detachment Epiretinal Membrane General Medicine Middle Aged medicine.disease Uveitis Anterior Acetonide Treatment Outcome medicine.anatomical_structure Intravitreal Injections Inner nuclear layer Disease Progression Female Epiretinal membrane medicine.symptom business Tomography Optical Coherence Uveitis |
| Zdroj: | Retina. 33:1673-1683 |
| ISSN: | 0275-004X |
| DOI: | 10.1097/iae.0b013e318285cc52 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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