Central Foveal Thickness Cut-off Value Identified for Corticosteroid Treatment in Intermediate Uveitis

AUGUST 16, 2016
Ellen Kurek
uveitis, best corrected visual acuity, cat-scratch fever, central foveal thickness, children, cystoid macular edema, idiopathic, inflammation, intermediate uveitis, Lyme disease, multiple sclerosis, ophthalmology, optical coherence tomography, pars plana, permanent vision loss, retinal vasculitis, sarcoidosis, systemic corticosteroid treatment, treatment response, visual outcome, vitreal snowballs, vitreousIntermediate uveitis (IU) is characterized by bilateral intraocular inflammation primarily in the vitreous and pars plana. IU comprises approximately 10% of all uveitis cases. It usually affects younger patients and is the second most common type of uveitis in children.

Most patients with IU do not appear to have any underlying disease. However, IU is sometimes associated with systemic diseases such as cat-scratch fever, Lyme disease, multiple sclerosis, and sarcoidosis. IU also occurs as an idiopathic disease, which is characterized by snow-banking or snowballs in the vitreous.

Common manifestations of IU include retinal vasculitis that mainly involves the venous branches as well as cystoid macular edema (CME), which occurs in 30% to 60% of cases and is the principal cause of permanent vision loss in IU patients. Early detection and treatment of CME is therefore critical for preserving vision in these patients.

Optical coherence tomography (OCT) has been used extensively to diagnose macular edema in patients with ocular inflammation, including those with IU, and has identified several predictors of visual outcome and response to treatment. However, one possible predictor that remained unevaluated in IU was subclinical macular thickening.

To determine the clinical significance of subclinical macular thickening in IU, an investigative team recruited 61 consecutive patients diagnosed with IU during a 6-year period at the Jules-Gonin Eye Hospital at the University of Lausanne in Lausanne, Switzerland.

In this prospective study, two subgroups of patients were identified on the basis of whether or not they needed systemic corticosteroid treatment. OCT was then used to measure central foveal thickness (CFT) in these subgroups as well as in a group of healthy volunteers (n = 27). CFT and best-corrected visual acuity (BCVA) in each group were then compared at baseline and after 6 months.

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