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Improving visual outcomes by preserving outer retina morphology in eyes with resolved pseudophakic cystoid macular edema.

Abstract：

PURPOSE:To use ultra-high-resolution optical coherence tomography (OCT) subclinical anatomic alterations to explain suboptimum vision despite pseudophakic cystoid macula edema (CME) resolution. SETTING:University of California-Davis, Sacramento, California, USA. DESIGN:Case study. METHODS:This study comprised patients who had cataract phacoemulsification surgery. Cases of resolved postoperative CME (diagnosed postoperatively by 1 month and resolved by 1 year) were included. Exclusion criteria included any other cause for decreased vision or compounding factors. Patients with a history of resolved pseudophakic CME were imaged using a purpose-built ultra-high-resolution OCT system with 4.5 μm axial resolution and an acquisition speed of 9 frames/sec (1000 A-scans/frame). The corrected distance visual acuity (CDVA) was determined by Early Treatment Diabetic Retinopathy Study standards. Statistical analysis was by the unpaired t test. A P value less than 0.05 was considered significant. RESULTS:The review identified 56 patients with a pseudophakic CME diagnosis at least 1 month postoperatively. Fifteen eyes (26.8%) had less than 20/20 CDVA despite resolution of CME; 7 participated. Four patients with 20/20 CDVA after resolution of pseudophakic CME participated. Eyes with reduced CDVA after macula edema showed ultra-high-resolution OCT evidence of blurring of outer segments of photoreceptors, while controls showed normal outer retina morphology (P<.05). CONCLUSIONS:Persistent anatomic alteration of photoreceptors visualized by ultra-high-resolution OCT correlated with reduced CDVA in patients with pseudophakic CME compared with patients who had 20/20 CDVA after macula edema. This anatomic alteration in outer photoreceptor morphology is a plausible explanation for the reduced CDVA in this disease. FINANCIAL DISCLOSURE:No author has a financial or proprietary interest in any material or method mentioned.

journal_name

J Cataract Refract Surg

journal_title

Journal of cataract and refractive surgery

authors

Hunter AA,Modjtahedi SP,Long K,Zawadzki R,Chin EK,Caspar JJ,Morse LS,Telander DG

doi

10.1016/j.jcrs.2013.09.018

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

626-31

issue

eissn

0886-3350

issn

1873-4502

pii

S0886-3350(14)00111-4

journal_volume

pub_type

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Improving visual outcomes by preserving outer retina morphology in eyes with resolved pseudophakic cystoid macular edema.