Macular thickening in acute anterior uveitis with a 6-month remission period

Moreno-Arrones, J. Paz; Gorroño-Echebarría, Marina Begoña; Teus, Miguel A.

doi:10.3129/i09-195

Cited by 6 publications

(8 citation statements)

References 4 publications

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“…The mechanism underlying the development of non-CME in eyes with iridocyclitis is unknown but is possibly caused by the same pathophysiological mechanisms underlying the development of CME in eyes with anterior uveitis. Although it has been suggested that the ring-like thickening outside the foveal center can persist for 6 months after an acute episode in 45 % of acute anterior uveitis cases [55], one study has shown that the OCT parameters including total macular volume return to normal by 6 months after the uveitis flare-up [58].…”

Section: Use Of Optical Coherence Tomography Technology In Uveitis Prmentioning

confidence: 99%

Optical coherence tomography imaging in uveitis

et al. 2013

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Section: Use Of Optical Coherence Tomography Technology In Uveitis Prmentioning

confidence: 99%

Optical coherence tomography imaging in uveitis

et al. 2013

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“…MT may occur in the course of an AU even in eyes without posterior segment disease, and it may or may not correspond to VA or the grade of anterior chamber inflammation [11,13-15]. The duration for MT after an AU episode has not been established [16]. Although inter-eye asymmetry has been used to demonstrate MT in uveitis-affected eyes [11,13], we did not find any literature reporting macular thickness values in fellow-eyes during an uveitis episode.…”

Section: Introductionmentioning

confidence: 99%

Bilateral macular thickening in mild unilateral anterior uveitis: is HLA-B27 involved?

2012

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BackgroundMacular thickening (MT) without clinically recognized macular edema has been described in anterior uveitis (AU). Although fellow-eyes of patients have been used as controls in several studies, little is known about macular thickness in these eyes. We studied the rate and extent of MT in both AU-affected and quiescent fellow-eyes of phakic AU patients with good visual acuity (VA). We also assessed macular thickness related to HLA-B27 presence and to recurrence, since these issues have been almost unexplored by previous optical coherence tomography (OCT) studies.MethodsPatients with AU were prospectively included and macular thickness was measured with OCT initially and on follow up. Macular thickness in patients’ affected eyes (n = 30) as well as in their quiet fellow-eyes (n = 28) was compared with eyes of age- and gender matched controls. Inter-ocular differences in macular thickness between AU affected eyes and their fellow-eyes were assessed in patients (n = 28), also in a subgroup with visual acuity ≥ 0.8 (n = 23) by one-sample Student’s t-tests. Inter-ocular differences were also assessed related to HLA-B27 presence and related to the status of current AU episode (initial or relapse).ResultsSubclinical MT is present in both quiet fellow-eyes and AU-affected eyes of patients. MT was found in most cases of AU, even in phakic eyes with good VA. There was a larger increase in macular thickness in HLA-B27-positive than in HLA-B27-negative patients. No differences in macular thickness were found between patients with their first AU episode and patients with recurrent episodes.ConclusionsMT probably reflects systemic immune-mediated response to the inflammatory disorder in AU, and it is possible that HLA-B27-related factors are involved in the pathogenesis of AU. These observations are in line with and extend the current understanding of the mechanisms behind MT in AU.

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“…Even in anterior uveitis without clinically apparent CME, the macula has been found to be thickened. 17,18 Consequently, although significant RNFL thinning is seen in the temporal quadrant in primary ocular hypertension, 28 we found significant thinning in the inferior quadrant in Uv-H. Therefore, we propose that RNFL thinning affecting the inferior quadrant may be suggestive of glaucomatous changes in eyes with uveitis.…”

Section: Discussionmentioning

confidence: 63%

“…Nonetheless, the effect of inflammation on the RNFL needs to be ascertained before considering its use for glaucoma detection in patients with uveitis. Certain ocular structures, such as the macula in anterior uveitis 17,18 in the absence of clinically detectable CME, were reported to be thickened in acute exacerbations, leading to the postulation that the inflammation is not confined to the anterior segment despite the clinical appearance.…”

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confidence: 99%

Evaluation of Retinal Nerve Fiber Layer Thickness in Eyes With Hypertensive Uveitis

et al. 2014

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IMPORTANCE Uveitic glaucoma is among the most common causes of irreversible visual loss in uveitis. However, glaucoma detection can be obscured by inflammatory changes.OBJECTIVE To determine whether retinal nerve fiber layer (RNFL) measurement can be used to detect glaucoma in uveitic eyes with elevated intraocular pressure (IOP). DESIGN, SETTING, AND PARTICIPANTSComparative case series of RNFL measurement using optical coherence tomography performed from May 1, 2010, through October 31, 2012, at a tertiary referral center. We assigned 536 eyes with uveitis (309 patients) in the following groups: normal contralateral eyes with unilateral uveitis (n = 72), normotensive uveitis (Uv-N) (n = 143), raised IOP and normal optic disc and/or visual field (Uv-H) (n = 233), and raised IOP and glaucomatous disc and/or visual field (Uv-G) (n = 88).EXPOSURES Eyes with uveitis and elevated IOP (>21 mm Hg) on at least 2 occasions. MAIN OUTCOMES AND MEASURES Comparison of RNFL values between groups of eyes and correlation with clinical data; risk factors for raised IOP, glaucoma, and RNFL thinning. RESULTS Mean (SD) global RNFL was thicker in Uv-N (106.4 [21.4] μm) compared with control (96.0 [9.0] μm; P < .001) eyes and was thicker in Uv-N eyes with active (119.6 [23.2] μm) compared with quiescent (102.3 [20.8] μm; P = .001) uveitis, which in turn was not significantly different from control eyes (P = .07). Compared with Uv-N eyes, significant RNFL thinning was seen in all quadrants except the temporal in Uv-G eyes and significant thinning in the inferior quadrant of Uv-H eyes with no evidence of disc or visual field changes (P = .03). Risk factors for elevated IOP were male sex and anterior uveitis. Age, higher peak IOP, longer duration of follow-up, and uveitis-induced elevation of IOP were risk factors for glaucoma and RNFL defect.CONCLUSIONS AND RELEVANCE Screening for glaucomatous RNFL changes in uveitis must be performed during quiescent periods. Thinning of the inferior quadrant suggests that glaucomatous damage, more than uveitic ocular hypertension, is in fact occurring. Measurement of RNFL may detect signs of damage before disc or visual field changes and therefore identifies a subgroup that should receive more aggressive treatment.

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Macular thickening in acute anterior uveitis with a 6-month remission period

Cited by 6 publications

References 4 publications

Optical coherence tomography imaging in uveitis

Optical coherence tomography imaging in uveitis

Bilateral macular thickening in mild unilateral anterior uveitis: is HLA-B27 involved?

Evaluation of Retinal Nerve Fiber Layer Thickness in Eyes With Hypertensive Uveitis

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