Tomographic assessment of therapeutic response to uveitic macular oedema
Tomographic assessment of therapeutic response to uveitic macular oedema
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DOI：
10.1111/j.1442-9071.2007.01577.x
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发表时间：
2007-11-01
影响因子：
4
通讯作者：
Lightman, Sue
中科院分区：
文献类型：
--
作者：
Sivaprasad, Sobha;Ikeji, Felicia;Lightman, Sue
用途：采用光学相干断层扫描（OCT）技术，对不同形态的葡萄膜炎性黄斑水肿和黄斑中心厚度的治疗效果进行评价。连续50例临床诊断为葡萄膜炎所致新发或复发性黄斑水肿的患者接受了为期1年的连续OCT检查。检查了不同类型的黄斑水肿（弥漫性黄斑水肿、内囊样水肿、外囊样水肿、视网膜内外层水肿和浆液性视网膜脱离）与logMAR视力变化之间的相关性，并记录了年龄、性别、与葡萄膜炎相关的全身性疾病、葡萄膜炎的位置和持续时间以及黄斑水肿的持续时间。对治疗的反应是以logMAR视力的变化和黄斑水肿模式的演变来衡量的。结果：弥漫性黄斑水肿、外部囊样和浆液性视网膜脱离对治疗反应良好。视网膜内层的囊肿对治疗更有抵抗力。在基线时两层均有囊肿的患者中，外层囊肿比内层囊肿消失得更快。多因素分析显示黄斑囊样水肿（所有类型）（P = 0.03）和内囊样水肿（P = 0.031）是与最终视力显著相关的变量。视网膜内囊样水肿比任何其他类型的水肿更难治疗。
Purpose: To evaluate the therapeutic effects on the different morphological patterns of uveitic macular oedema and central macular thickness using optical coherence tomography (OCT).Methods: Retrospective observational case series. Fifty consecutive patients with a clinical diagnosis of new or recurrent macular oedema due to uveitis were examined with serial OCTs for 1 year. The correlation between different patterns of macular oedema (diffuse macular oedema, inner cystoid oedema, outer cystoid oedema, oedema involving both inner and outer layers of retina and serous retinal detachment) and change in logMAR visual acuity and the recorded variables including age, gender, systemic disease associated with uveitis, location and duration of uveitis, and duration of macular oedema were examined. Response to treatment was measured as change in logMAR visual acuity and evolution of patterns of macular oedema.Results: Diffuse macular oedema, external cystoid and serous retinal detachment responded well to treatment. Cysts in the inner retinal layers were more resistant to treatment. The cysts in the outer layers disappeared faster than cysts in the inner layers in patients with cysts in both layers at baseline. Multivariate analysis showed that cystoid macular oedema (all types) (P = 0.03) and inner cystoid oedema (P = 0.031) were the variables significantly associated with final visual acuity.Conclusion: Assessment of patterns of uveitic macular oedema by OCT gives useful information on the prognosis. Inner retinal cystoid oedema is more resistant to treatment than any other patterns of oedema.