Screening for cystoid macular oedema in children with uveitis using the retinal thickness analyser

Acta Ophthalmol. 2008 May;86(3):292-6. doi: 10.1111/j.1600-0420.2007.01009.x. Epub 2007 Sep 4.

Abstract

Purpose: This study aimed to investigate the retinal thickness analyser (RTA) as a means to identify the presence of cystoid macular oedema (CMO) in children with uveitis, whether the course of CMO can be monitored using this method, and whether there is a trend towards a correlation between macular oedema and visual acuity (VA) in children.

Methods: This prospective, cross-sectional study with observer-blinded analysis included 25 eyes. Standardized testing for best corrected distance VA (d-VA), near (reading) VA (n-VA) and slit-lamp examination were conducted. Using the RTA, a 3 x 3-mm scan of the macula was obtained, which was then used to discern CMO and calculate mean foveal thickness (MFT).

Results: Macular scanning was possible in all children. Cystoid macular oedema was discerned in 10 eyes (40%) and ruled out in 15. In CMO eyes, d-VA was 0.5 Snellen and n-VA was 2 Jaeger; neither result differed significantly from those in eyes without CMO. Mean foveal thickness correlated with n-VA (r = 0.511, p = 0.015), but not with d-VA (r = 0.271, p = 0.191). After 3 months of tailored therapy, CMO was still detectable in six eyes. Changes in d-VA in the CMO and non-CMO groups were 3 +/- 2.1 and 0.8 +/- 1.8 Snellen, respectively; changes in n-VA were 1 +/- 1.4 and 0.1 +/- 0.3 Jaeger, respectively. Changes in MFT were - 244.8 +/- 137.4 microm and - 0.8 +/- 18.1 microm, respectively. A statistically significant correlation was found between the changes in MFT and n-VA (r = 0.629), but not with that in d-VA (r = 0.292).

Conclusions: We used the RTA to establish the presence or absence of CMO according to measurements of the macular region. Our findings show that CMO is a common complication in children with uveitis and can be present even in cases with good d-VA. Mean foveal thickness as measured with the RTA correlates indirectly with n-VA.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Diagnostic Techniques, Ophthalmological / instrumentation*
  • Female
  • Follow-Up Studies
  • Humans
  • Macula Lutea / pathology
  • Macular Edema / etiology*
  • Macular Edema / pathology*
  • Macular Edema / physiopathology
  • Male
  • Prospective Studies
  • Retina / pathology*
  • Single-Blind Method
  • Uveitis / complications*
  • Visual Acuity