3 research outputs found

    Estudio mediante OCT del comportamiento de los puntos hiperreflectivos en el edema macular uveítico no infeccioso

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    186 p.Las uveítis no infecciosas son un grupo heterogéneo de enfermedades inflamatorias intraoculares de origen autoinmune. Puede presentarse en el contexto de una enfermedad autoinmune sistémica o bien aisladamente. Afecta con mayor frecuencia a pacientes jóvenes o de mediana edad y la causa más frecuente de pérdida de visión es el edema macular. La Tomografía de Coherencia Óptica es una técnica diagnóstica de imagen no invasiva que permite evaluar las características del edema macular como el grosor de la mácula y la presencia de puntos hiperreflectivos, que se cree corresponden a células de la microglía. En esta tesis hemos evaluado el comportamiento de dichos puntos a lo largo del tiempo en cuanto a su número y distribución en las capas de la retina tras el tratamiento del edema macular y hemos valorado su utilidad como biomarcadores pronóstico. Hemos hallado que la disminución del grosor macular central se asocia tanto con la redistribución hacia las capas más internas de la retina de los puntos, como con la reducción del número total de los mismos. El número de puntos hiperreflectivos se reduce de forma paralela al desplazamiento de dichos puntos a las capas más internas de la retina en pacientes con reducción del grosor macular central. La agudeza visual sin embargo, no se asoció con el número de puntos hiperreflectivos ni con la distribución de los mismos en la retina

    Predictors for functional and anatomic outcomes in macular edema secondary to non-infectious uveitis

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    Aims We aimed to investigate predictive factors for visual and anatomic outcomes in patients with macular edema secondary to non-infectious uveitis. Material and methods 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 mu m 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 mm(2) 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 mu m) within a 12 month period. Results 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. Conclusion 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.This work was supported by grants from: Spanish Ministry of Economy, Industry and Competitivity, Carlos III Health Institute, cofinanced by the European Regional Development Fund, identification number: PI13/02148, Principal Investigator: AA; http://www.eng.isciii.es/ISCIII/es/contenidos/fd-investigacion/financiacion.shtml.The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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