Clinic Institute of Ophthalmology (ICOF), Hospital Clinic of Barcelona, Barcelona, Spain.
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
PLoS One. 2019 Jan 24;14(1):e0210799. doi: 10.1371/journal.pone.0210799. eCollection 2019.
We aimed to investigate predictive factors for visual and anatomic outcomes in patients with macular edema secondary to non-infectious uveitis.
We conducted a multicenter, prospective, observational, 12-month follow-up study. Participants included in the study were adults with non-infectious uveitic macular edema (UME), defined as central subfoveal thickness (CST) of >300 μm as measured by spectral domain optical coherence tomography (SD-OCT) and fluid in the macula. Demographic, clinical and tomographic data was recorded at baseline, 1, 3, 6 and 12 months. Foveal-centered SD-OCT exploration was set as the gold-standard determination of UME using a standard Macular Cube 512x128 A-scan, within a 6 x 6 mm2 area, and the Enhanced High Definition Single-Line Raster. To assess favorable prognosis, the main outcomes analyzed were the best-corrected visual acuity (BCVA) and the CST. Favorable prognosis was defined as sustained improvement of BCVA (2 lines of gain of the Snellen scale) and CST (decrease of 20% of the initial value or <300 μm) within a 12 month period.
Fifty-six eyes were analyzed. The number of eyes with sustained improvement in the CST was 48 (86.2%), against 23 (41.1%) eyes with sustained improvement in BCVA. Favorable prognosis, as defined above, was observed in 18 (32.1%) eyes. UME prognosis was negatively correlated with baseline foveal thickening, alteration in the vitreo-macular interface and cystoid macular edema. In contrast, bilaterally, systemic disease and the presence of anterior chamber cells were predictive of favorable prognosis.
Available treatment modalities in UME may avoid chronic UME and improve anatomic outcome. However, the proportion of functional amelioration observed during 12 months of follow-up is lower. Thicker CST, alteration in the vitreo-macular interface and cystoid macular edema may denote less favorable prognosis. Conversely, bilaterally, systemic disease and anterior chamber cells may be associated with favorable prognosis in UME.
我们旨在研究非感染性葡萄膜炎继发黄斑水肿患者的预测因子，包括视力和解剖学结局。
我们进行了一项多中心、前瞻性、观察性、12 个月随访研究。研究纳入的对象为非感染性葡萄膜炎性黄斑水肿（UME）患者，定义为谱域光学相干断层扫描（SD-OCT）测量的中央黄斑区视网膜下厚度（CST）>300μm，且黄斑区存在液体积聚。在基线、1、3、6 和 12 个月时记录人口统计学、临床和影像学数据。使用标准黄斑立方 512x128 A 扫描和增强高清单线光栅，对中央凹为中心的 SD-OCT 进行扫描，以确定 UME，扫描范围为 6x6mm2。为了评估预后，主要分析的结局是最佳矫正视力（BCVA）和 CST。预后良好定义为 12 个月内 BCVA（提高 2 行 Snellen 视力表）和 CST（初始值降低 20%或<300μm）持续改善。
分析了 56 只眼。CST 持续改善的眼有 48 只（86.2%），BCVA 持续改善的眼有 23 只（41.1%）。如前所述，18 只眼（32.1%）预后良好。UME 的预后与基线黄斑区厚度、玻璃体黄斑界面改变和囊样黄斑水肿有关。相反，双侧全身性疾病和前房细胞的存在与预后良好相关。
UME 现有的治疗方法可能避免慢性 UME 并改善解剖学结局。然而，在 12 个月的随访中观察到的功能改善比例较低。更厚的 CST、玻璃体黄斑界面改变和囊样黄斑水肿可能预示着预后较差。相反，双侧全身性疾病和前房细胞可能与 UME 的良好预后相关。
