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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 626-631 |
| Number of pages | 6 |
| Journal | Journal of Cataract and Refractive Surgery |
| Volume | 40 |
| Issue number | 4 |
| DOIs | |
| State | Published - 2014 |
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ASJC Scopus subject areas
- Ophthalmology
- Sensory Systems
- Surgery
Cite this
Improving visual outcomes by preserving outer retina morphology in eyes with resolved pseudophakic cystoid macular edema. / Hunter, Allan A.; Modjtahedi, Sara P.; Long, Kuumba; Zawadzki, Robert; Chin, Eric K.; Caspar, Jeffrey J; Morse, Lawrence S; Telander, David G.
In: Journal of Cataract and Refractive Surgery, Vol. 40, No. 4, 2014, p. 626-631.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Improving visual outcomes by preserving outer retina morphology in eyes with resolved pseudophakic cystoid macular edema
AU - Hunter, Allan A.
AU - Modjtahedi, Sara P.
AU - Long, Kuumba
AU - Zawadzki, Robert
AU - Chin, Eric K.
AU - Caspar, Jeffrey J
AU - Morse, Lawrence S
AU - Telander, David G.
PY - 2014
Y1 - 2014
N2 - 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.
AB - 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.
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U2 - 10.1016/j.jcrs.2013.09.018
DO - 10.1016/j.jcrs.2013.09.018
M3 - Article
C2 - 24529660
AN - SCOPUS:84898600582
VL - 40
SP - 626
EP - 631
JO - Journal of Cataract and Refractive Surgery
JF - Journal of Cataract and Refractive Surgery
SN - 0886-3350
IS - 4
ER -