Influence of the vitreomacular interface on the efficacy of intravitreal therapy for uveitis-associated cystoid macular oedema.

Abstract

PURPOSE:

To evaluate the effect of the vitreomacular interface (VMI) on treatment efficacy of intravitreal therapy in uveitic cystoid macular oedema (CME).

METHODS:

Retrospective analysis of CME resolution, CME recurrence rate and monthly course of central retinal thickness (CRT), retinal volume (RV) and best corrected visual acuity (BCVA) after intravitreal injection with respect to the VMI configuration on spectral-domain OCT using chi-squared test and repeated measures anova adjusted for confounding covariates epiretinal membrane, administered drug and subretinal fluid.

RESULTS:

Fifty-nine eyes of 53 patients (mean age: 47.4 ± 16.9 years) were included. VMI status had no effect on complete CME resolution rate (p = 0.16, corrected p-value: 0.32), time until resolution (p = 0.09, corrected p-value: 0.27) or CME relapse rate (p = 0.29, corrected p-value: 0.29). Change over time did not differ among the VMI configuration groups for BVCA (p = 0.82) and RV (p = 0.18), but CRT decrease was greater and faster in the posterior vitreous detachment (PVD) group compared to the posterior vitreous attachment (PVA) and vitreous macular adhesion (VMA) groups (p = 0.04). Also, the percentage of patients experiencing a ≥ 20% CRT thickness decrease after intravitreal injection was greater in the PVD group (83%) compared to the VMA (64%) and the PVA (16%) group (p = 0.027), however, not after correction for multiple testing (corrected p-value: 0.11).

CONCLUSION:

The VMI configuration seems to be a factor contributing to treatment efficacy in uveitic CME in terms of CRT decrease, although BCVA outcome did not differ according to VMI status.

• Authors: Marion R Munk, Radha Ram, Alfred Rademaker, Dachao Liu, Vikram Setlur, Felix Chau, Ursula Schmidt-Erfurth, Debra A Goldstein
• Journal: Acta ophthalmologica (Acta Ophthalmol) Vol. 93 Issue 7 Pg. e561-7 (Nov 2015) ISSN: 1755-3768 [Electronic] England
• PMID: 25708777 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Chemical References

• Angiogenesis Inhibitors
• Drug Implants
• Glucocorticoids
• Bevacizumab
• Dexamethasone
• Triamcinolone Acetonide

Topics

• Adult
• Angiogenesis Inhibitors (therapeutic use)
• Bevacizumab (therapeutic use)
• Dexamethasone (therapeutic use)
• Drug Implants
• Eye Diseases (physiopathology)
• Female
• Glucocorticoids (therapeutic use)
• Humans
• Intravitreal Injections
• Macular Edema (drug therapy, physiopathology)
• Male
• Middle Aged
• Retinal Diseases (physiopathology)
• Retrospective Studies
• Tissue Adhesions (physiopathology)
• Tomography, Optical Coherence
• Treatment Outcome
• Triamcinolone Acetonide (therapeutic use)
• Uveitis (drug therapy, physiopathology)
• Visual Acuity (physiology)
• Vitreous Body