First Author: M.La Cava ITALY
Co Author(s): P. Tortorella E. D'Ambrosio F. De Marco E. Santoro L. Iannetti 0 0 0 0 0 0 0 0 0
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To investigate the correlation between best-corrected visual acuity (BCVA) and foveal inner segment/outer segment (IS/OS) junction and the cone outer segment tips (COST) line integrity in eyes with uveitic macular edema.
Retrospective, observational study. Diagnostic Chorioretinal Service, Department of Ophthalmology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Fifty-two eyes of 33 patients affected by uveitis complicated by macular edema with a median age of 32 years (range: 9-77 years) were included in the study. Uveitis was anterior in 12 eyes (23.07%), intermediate in 20 (38.46%), posterior in 7 (13.46%) and diffuse in 13 (25%). The BCVA using Snellen charts was performed. All patients underwent spectral-domain Optical Coherence Tomography (SD-OCT) examination with Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany). 20x15 degree raster scans were performed consisting of 37 high-resolution horizontal B-scans. The correlation between the BCVA and macular edema pattern, the integrity of the foveal IS/OS junction and COST line was evaluated with a multivariate correlation. The correlation between the interruption of the foveal IS/OS junction and COST line was analyzed with a univariate logistic correlation.
Median duration of uveitis at the examination was 48 months (1°-3° quartile (q): 2-204 months). Median BCVA was 0.6 (q: 0.03-1.0). SD-OCT revealed cystoid macular edema (CME) in 13 eyes (25%), diffuse macular edema (DME) in 39 eyes (75%) and foveal serous retinal detachment in 11 eyes (21.15%). Median BCVA in eyes with DME was 0.7 (q: 0.03-1.0), in eyes with CME was 0.6 (q: 0.06-1.0). IS/OS segment interruption was observed in 26 eyes (50%), COST line interruption in 13 eyes (25%). Median BCVA in eyes with IS/OS junction interruption was 0.35 (q: 0.06-1.0) and 0.2 (q: 0.06-0.8) in eyes with COST line interruption. The multivariate analysis showed a negative correlation between BCVA and central retinal thickness (p<0.001), cystoid pattern of edema (p<0.05) and COST line interruption (p<0.01). The univariate logistic analysis showed a strong correlation between IS/OS segment and COST line integrity (p<0.05).
IS/OS segment defect and COST line interruption and central retinal thickness are correlated with poor vision. Also visual acuity is strongly affected by the cystoid pattern. The COST line integrity appears to be the most important factor in the visual prognosis of uveitic macular edema.