ANALYSIS OF CYSTOID MACULAR EDEMA AFTER CATARACT SURGERY

白内障术后黄斑囊样水肿分析

• 批准号: 7378945
• 负责人: Douglas A Jabs
• 金额: $ 0.12万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-12-01 至 2006-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7378945
• 关键词: ANALYSIS; CYSTOID; MACULAR; EDEMA; AFTER

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Analysis of Cystoid Macular Edema after Cataract Surgery in Patients with and without Uveitis using Optical Coherence Tomography. Division of Ocular Immunology, Wilmer Eye Institute, Johns Hopkins Hospital. Introduction: Uveitis is the sixth leading cause of visual impairment in developed countries. Cataract formation is common in uveitis, and cystoid macular edema (CME) is a major cause of long-term visual loss after cataract surgery. Optical coherence tomography (OCT) is a new method for high-resolution cross-sectional imaging that directly measures retinal thickness. OCT has been shown to be highly reproducible and is well tolerated, safe and quick to perform. Although widely recognized, the true incidence of CME in patients with uveitis after cataract surgery has not been clearly defined. Incidence of CME determined from OCT testing may allow for more precise risk stratification, and translate into more timely treatment and targeted prophylaxis for high-risk patients. Objectives: The objectives of this study are: 1) To assess the incidence and progression of CME after cataract surgery in patients with uveitis using OCT and to correlate this with the type of uveitis and other known risk factors. 2) To compare the incidence or progression of CME after cataract surgery between patients with and without uveitis using OCT. Methods: Study participants consist of a consecutive cohort of patients with uveitis and without uveitis (control group) scheduled for routine cataract surgery. A total of 50 patients will be enrolled in each group. Patients included in the uveitis group have documented evidence of non-infectious chronic uveitis (duration more than 3 months) or recurrent uveitis (2 or more episodes, separated by at least 3 months) involving one or more segments of the eye (anterior, intermediate, posterior). Patients without a prior history of uveitis are eligible for inclusion in the control group. For both groups, subjects with an established diagnosis of diabetes or other retinal pathology affecting macular thickness are excluded. For each study eye, OCT testing is performed no more than 4 weeks prior to the date of surgery, 1 month after the surgery and 3 months after the surgery. Clinical examination including best corrected visual acuity, ocular inflammation and fundus examination, is recorded for pre-operative visit, and post-operative 1 and 3 months visits. Patient characteristics, including age, gender, race, type and duration of uveitis, past ocular and medical history, medication use, peri-operative administration of corticosteroids and other immunosuppressive agents, type and complications of surgery, are recorded for each study eye. The Fisher's exact test will be used to analyze proportion of participants developing CME at 1 and 3 months among the uveitis and control groups. Secondary outcomes such as mean changes in foveal thickness and visual acuity will be compared among groups using the Wilcoxon test. Regression models will be used to investigate statistical associations between the incidence of CME and related risk factors such as duration of uveitis, prior history of macular edema, and anatomical location of uveitis. Results: The results are not available. Conclusions: Information obtained from this study may allow us to correlate incidence and progression of CME after cataract surgery with type of uveitis and other risks factors. We hope this study provides information that translates into early treatment and targeted prophylaxis for CME after cataract surgery in high-risk patients.

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。葡萄膜炎和非葡萄膜炎患者白内障术后黄斑囊样水肿的光学相干断层扫描分析约翰霍普金斯医院威尔默眼科研究所眼免疫科。前言：葡萄膜炎是发达国家导致视力损害的第六大原因。白内障的形成在葡萄膜炎中很常见，囊样黄斑水肿(CME)是白内障手术后长期视力丧失的主要原因。光学相干层析成像(OCT)是一种直接测量视网膜厚度的高分辨率断层成像新方法。OCT已被证明是高度可重复性的，耐受性好，安全和快速执行。虽然人们普遍认为，白内障手术后葡萄膜炎患者的CME的真实发生率还没有明确的定义。通过OCT测试确定的CME发生率可能会允许更精确的风险分层，并转化为更及时的治疗和针对高危患者的有针对性的预防。目的：本研究的目的是：1)评估使用OCT的葡萄膜炎患者白内障手术后CME的发生率和进展，并将其与葡萄膜炎的类型和其他已知的危险因素相关联。2)应用OCT检查比较有无葡萄膜炎患者白内障术后CME的发生率及进展情况。方法：研究参与者包括一组连续的接受常规白内障手术的葡萄膜炎患者和非葡萄膜炎患者(对照组)。每组共有50名患者入选。包括在葡萄膜炎组的患者有证据表明，非传染性慢性葡萄膜炎(持续时间超过3个月)或复发性葡萄膜炎(2次或更多发作，间隔至少3个月)涉及眼部的一个或多个节段(前、中、后)。没有葡萄膜炎病史的患者有资格被纳入对照组。对于这两组患者，已确诊为糖尿病或其他影响黄斑厚度的视网膜病变的受试者都被排除在外。对于每个研究眼，OCT测试在手术日期前不超过4周，手术后1个月和3个月后进行。临床检查包括最佳矫正视力、眼部炎症和眼底检查，记录术前随访、术后1个月和3个月随访。每只研究眼记录患者的特征，包括年龄、性别、种族、葡萄膜炎的类型和持续时间、既往的眼睛和病史、药物使用、围手术期皮质类固醇和其他免疫抑制剂的使用、手术的类型和并发症。Fisher‘s精确测试将用于分析葡萄膜炎组和对照组在1个月和3个月时发生CME的参与者的比例。次要结果，如中心凹厚度和视力的平均变化，将使用Wilcoxon检验在不同组之间进行比较。回归模型将被用来研究CME的发生率与相关危险因素之间的统计关系，如葡萄膜炎的持续时间、黄斑水肿史以及葡萄膜炎的解剖位置。结果：结果不详。结论：从这项研究获得的信息可能使我们能够将白内障手术后CME的发生率和进展与葡萄膜炎的类型和其他危险因素联系起来。我们希望这项研究为高危患者白内障术后CME的早期治疗和有针对性的预防提供信息。