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Optical Coherence Tomography Anatomic and Temporal Biomarkers in Uveitic Macular Edema.

Publication ,  Journal Article
Ciulla, TA; Kapik, B; Barakat, MR; Khurana, RN; Nguyen, QD; Grewal, DS; Albini, T; Cunningham, ET; Goldstein, DA
Published in: Am J Ophthalmol
May 2022

PURPOSE: To assess the relationship between best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) features in noninfectious uveitis (NIU)-related macular edema. DESIGN: Clinical cohort study from post hoc analysis of 2 phase 3 clinical trials. METHODS: Correlation and longitudinal treatment analyses were performed. Of 198 patients with NIU, 134 received suprachoroidal CLS-TA (proprietary formulation of a triamcinolone acetonide injectable suspension), and 64 received sham, with 12.9% and 72%, respectively, receiving rescue therapy. RESULTS: At baseline, mean BCVA progressively worsened with each ordinal drop in central subfield ellipsoid zone (EZ) integrity. Eyes with normal baseline EZ experienced greater 24-week change in BCVA versus those with some degree of baseline EZ disruption (11.9 vs 9.4 letters, P = .006). In contrast, eyes with baseline central subfield cystoid spaces and/or subretinal fluid showed more improvement (13.7 or 17.2 letters, respectively) at 24 weeks, versus those without such findings (5.5 [P = .012] or 9.5 letters [P < .001], respectively). Longitudinal modeling for CLS-TA-treated eyes showed that central subfield thickness (CST) reached 90% of maximal improvement by week 3, whereas 90% maximal response in BCVA was not reached until week 9. CLS-TA-treated eyes that showed CST reduction of ≥50 µm at 4 weeks experienced a greater 24-week improvement in BCVA versus those without such an early response (14.6 vs 6.5 letters, P = .006 for difference). CONCLUSIONS: Pretreatment EZ integrity and the presence of central subfield cystoid spaces or subretinal fluid each predict improved therapeutic response to treatment in eyes with NIU. In CLS-TA treated eyes, longitudinal modeling shows CST improvement preceding BCVA improvement.

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Published In

Am J Ophthalmol

DOI

EISSN

1879-1891

Publication Date

May 2022

Volume

237

Start / End Page

310 / 324

Location

United States

Related Subject Headings

  • Visual Acuity
  • Uveitis
  • Treatment Outcome
  • Tomography, Optical Coherence
  • Ophthalmology & Optometry
  • Macular Edema
  • Intravitreal Injections
  • Humans
  • Follow-Up Studies
  • Cohort Studies
 

Citation

APA
Chicago
ICMJE
MLA
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Ciulla, T. A., Kapik, B., Barakat, M. R., Khurana, R. N., Nguyen, Q. D., Grewal, D. S., … Goldstein, D. A. (2022). Optical Coherence Tomography Anatomic and Temporal Biomarkers in Uveitic Macular Edema. Am J Ophthalmol, 237, 310–324. https://doi.org/10.1016/j.ajo.2021.10.024
Ciulla, Thomas A., Barry Kapik, Mark R. Barakat, Rahul N. Khurana, Quan Dong Nguyen, Dilraj S. Grewal, Thomas Albini, Emmett T. Cunningham, and Debra A. Goldstein. “Optical Coherence Tomography Anatomic and Temporal Biomarkers in Uveitic Macular Edema.Am J Ophthalmol 237 (May 2022): 310–24. https://doi.org/10.1016/j.ajo.2021.10.024.
Ciulla TA, Kapik B, Barakat MR, Khurana RN, Nguyen QD, Grewal DS, et al. Optical Coherence Tomography Anatomic and Temporal Biomarkers in Uveitic Macular Edema. Am J Ophthalmol. 2022 May;237:310–24.
Ciulla, Thomas A., et al. “Optical Coherence Tomography Anatomic and Temporal Biomarkers in Uveitic Macular Edema.Am J Ophthalmol, vol. 237, May 2022, pp. 310–24. Pubmed, doi:10.1016/j.ajo.2021.10.024.
Ciulla TA, Kapik B, Barakat MR, Khurana RN, Nguyen QD, Grewal DS, Albini T, Cunningham ET, Goldstein DA. Optical Coherence Tomography Anatomic and Temporal Biomarkers in Uveitic Macular Edema. Am J Ophthalmol. 2022 May;237:310–324.
Journal cover image

Published In

Am J Ophthalmol

DOI

EISSN

1879-1891

Publication Date

May 2022

Volume

237

Start / End Page

310 / 324

Location

United States

Related Subject Headings

  • Visual Acuity
  • Uveitis
  • Treatment Outcome
  • Tomography, Optical Coherence
  • Ophthalmology & Optometry
  • Macular Edema
  • Intravitreal Injections
  • Humans
  • Follow-Up Studies
  • Cohort Studies