Sivaprasad Sobha, Ikeji Felicia, Xing Wen, Lightman Sue
Moorfields Eye Hospital, London, UK.
Clin Exp Ophthalmol. 2007 Nov;35(8):719-23. doi: 10.1111/j.1442-9071.2007.01577.x.
To evaluate the therapeutic effects on the different morphological patterns of uveitic macular oedema and central macular thickness using optical coherence tomography (OCT).
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.
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.
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.
使用光学相干断层扫描（OCT）评估葡萄膜炎性黄斑水肿的不同形态模式及黄斑中心厚度的治疗效果。
回顾性观察病例系列。连续50例临床诊断为新发或复发性葡萄膜炎所致黄斑水肿的患者接受了为期1年的系列OCT检查。研究黄斑水肿的不同模式（弥漫性黄斑水肿、内层囊样水肿、外层囊样水肿、累及视网膜内外层的水肿及浆液性视网膜脱离）与logMAR视力变化之间的相关性，以及记录的变量，包括年龄、性别、与葡萄膜炎相关的全身性疾病、葡萄膜炎的部位和病程，以及黄斑水肿的病程。以logMAR视力变化和黄斑水肿模式的演变来衡量治疗反应。
弥漫性黄斑水肿、外层囊样水肿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具抵抗力。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，囊样黄斑水肿（所有类型）（P = 0.03）和内层囊样水肿（P = 0.031）是与最终视力显著相关的变量。
通过OCT评估葡萄膜炎性黄斑水肿模式可为预后提供有用信息。视网膜内层囊样水肿比其他任何水肿模式对治疗更具抵抗力。
