Course of macular edema in uveitis under medical treatment
Course of macular edema in uveitis under medical treatment
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DOI：
10.1080/09273940701244509
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发表时间：
2007-03-01
影响因子：
3.3
通讯作者：
Kouvatseas, George
中科院分区：
文献类型：
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作者：
Markomichelakis, Nikos N.;Halkiadakis, Ioannis;Kouvatseas, George
目的：应用光学相干断层扫描(OCT)观察葡萄膜黄斑水肿对不同治疗方法的反应。方法：这是一项对连续葡萄膜炎患者进行的前瞻性研究，这些患者至少有一只眼伴有黄斑水肿。患者接受了治疗。分别于治疗后1、3、6、12个月进行最佳矫正Snellen视力(BCVA)和黄斑厚度测量等黄斑CT检查。结果：分析了58例81只眼的临床资料。黄斑水肿完全消退38只眼(47%)。平均BCVA在研究开始时为最小分辨角度的对数20/34(-logMAR，0.2+/-0.3)，20/27(对数MAR，0。13+/-0.29)。差异有统计学意义(p=0.04)。相应的中心凹视网膜厚度在研究开始时为319+/-150/平方公尺，而在12个月时为241+/-125TTM(p<；0.001)。黄斑厚度的减少与BCVA的改善之间存在微弱但有统计学意义的相关性(r=0.3，p0.01)。与基线相比，43只持续黄斑水肿者中有13只眼(30%)黄斑厚度减少超过15%，而10只眼(23.3%)黄斑厚度增加超过15%。统计分析表明，视网膜前膜的存在和弥漫性黄斑水肿的OCT模式是与药物治疗失败相关的重要因素。结论：本研究显示葡萄膜炎黄斑水肿经内科治疗后总体视力预后良好。视网膜前膜的存在是导致治疗失败的一个重要因素。
Objective: To describe the response of uveitic macular edema to various treatment methods using optical coherence tomography (OCT). Methods: This is a prospective study of consecutive uveitis patients with macular edema in at least one eye. The patients received medical treatment. Best corrected Snellen Visual Acuity (BCVA) and tomographic features of the macula, including macular thickness measurement, were obtained at one, three, six, and 12 months after commencing treatment. Results: Eighty-one eyes of 58 patients were analyzed. Complete resolution of macular edema occurred in 38 eyes (47%). The average BCVA was 20/34 logarithm of minimum angle of resolution (-logMAR, 0.2 +/- 0.3) upon study entry and 20/27 (logMAR, 0. 13 +/- 0.29) upon study completion. The difference was statistically significant (p = 0.04). The corresponding mean retinal thickness at the central fovea was 319 +/- 150 /mu m at the beginning of the study compared to 241 +/- 125 ttm at 12 months (p < 0.001). A weak but statistically significant correlation between the reduction of macular thickness and the improvement of BCVA (r = 0.3, p 0.01) was found. Thirteen of the 43 eyes (30%) with persistent macular edema had a more than 15% reduction of macular thickness compared to baseline, whereas 10 eyes (23, 3%) had a more than 15% increase in macular thickness. Statistical analysis indicated that the presence of an epiretinal membrane and an OCT pattern of diffuse macular edema was a significant factor associated with medical treatment failure. Conclusion: This study demonstrates the overall favorable visual prognosis of uveitic macular edema under medical treatment. The presence of an epiretinal membrane is an important factor associated with medical treatment failure.