The authors of this article summarized their experience using optical coherence tomography (OCT) in uveitic macular edema patients. The article provides helpful information for uveitis and retina specialists, as well as general ophthalmologists with an interest in uveitis and macular edema. The authors found that OCT was effective at diagnosing macular edema in uveitis patients, and the results appeared to correlate well with fluorescein angiography (FA) findings. However, OCT performed better than FA at visualizing retinal thickness and structure.
The objectives of this study were to associate OCT patterns with fluorescein angiography (FA) findings, investigate the correlation between OCT features and visual acuity, and determine the impact of OCT patterns on visual prognosis over time. The authors studied 129 eyes of 90 patients with uveitic macular edema.
OCT and FA findings were similar for 112 eyes (86.8 percent). The researchers identified three patterns of macular edema: diffuse macular edema (DME), cystoid macular edema (CME), and serous retinal detachment (SRD). Thirty-eight percent of the patients had DME, and 51 percent had CME. A small proportion of patients with DME or CME had concomitant SRD. Epiretinal membrane was detected by OCT in 21 percent of eyes and vitreomacular traction in 4.7 percent.
There was a strong correlation between poor visual acuity and increasing central thickness measured by OCT, particularly among those with CME. However, this relationship was not statistically significant among patients with DME. Patients with CME or SRD experienced better visual recovery over time than did patients with DME.
The patterns of uveitic macular edema reported in this article were similar to those that have previously been observed in diabetic macular edema patients. However, patients with SRD experienced better visual recovery than their counterparts with diabetic macular edema. Interestingly, SRD did not appear to correlate with poor visual acuity, and visual recovery was in fact good in these patients, a finding that has not been observed among diabetic macular edema patients.
Unfortunately, the authors did not provide specific details regarding how the patients in each subgroup were treated, and the follow-up period was short. Perhaps the DME patients would have experienced improved visual outcomes with longer or more aggressive treatment, or perhaps they were more likely to have concomitant vitreomacular traction or epiretinal membranes.
Dr. Thorne has no financial relationships to disclose.