First Author: S.Degli Esposti UK
Co Author(s): M. Mehat O. Comyn A. Quartilho G. Rubin N. Okhravi M. Michaelides
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To outline secondary outcome efficacy measures of the LIMO trial which evaluated safety and efficacy of intravitreal Lucentis in patients with quiescent uveitis and visual loss secondary to uveitic macular oedema proven to be refractory or ineligible to standard of care therapy.
Moorfields Eye Hospital, London, UK.
Open label, prospective, non-randomised, interventional case series. Ten patients (5 male) with uveitic macular oedema and quiescent uveitis were enrolled. Median age was 56.1 years (IQR 37.4, 68.2). All patients initially received 3 monthly injections of Lucentis following by re-injection according to clinical need in the study eye. Patients underwent baseline and serial assessments over a 12 month period. The primary endpoint of the study was the number of eyes which responded to therapy with reduction of macular oedema as evaluated by OCT (previously presented at Euretina, Nice 2015). Secondary outcome efficacy measures included change in contrast sensitivity, change in retinal sensitivity on microperimetry and change in reading speed.
At enrolment, median visual acuity in the study eye was 64 ETDRS letters (58, 68) and median contrast sensitivity in the study eye was 1.33 (1.20, 1.55). At 6 months and at 12 months median visual acuity was 68 (53, 80) and 60 (42, 78) respectively. At 12 months median change in contrast sensitivity was 0.03 (-0.45, 0.65), median change in reading speed was 21.5 (-50, 36) and median change in macular sensitivity on microperimetry was 7.5 dB (-0.2, 13.2). Change in volumetric retinal sensitivity from baseline in dB-sr has been plotted for the study eye and the fellow eye over the one year follow up for each participant. Three patients showed clear improvement of retinal sensitivity in the study eye as compared with the control eye, and two of these cases maintained the improvement to 12 months. The topographical microperimetry sensitivity gain in these cases has been plotted against retinal structure on OCT, with the areas of improved sensitivity correlating with areas of reduction of macular oedema.
In our cohort of patients, the regions of the retina with sensitivity improvement on microperimetry corresponded well with the regions of anatomical improvement, as seen on OCT. The use of microperimetry should be taken into consideration when designing clinical trials as it adds value to the evaluation of safety and effectiveness as shown with visual acuity and OCT findings, to better understand structure-function associations.