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The effect of pars plana vitrectomy on cystoid macular oedema associated with chronic uveitis: a randomised, controlled pilot study
  1. P Tranos,
  2. R Scott,
  3. H Zambarajki,
  4. W Ayliffe,
  5. C Pavesio,
  6. D G Charteris
  1. Department of Vitreoretinal Surgery, Moorfields Eye Hospital, London EC1V 2PD, UK
  1. Correspondence to: David Charteris Department of Vitreoretinal Surgery, Moorfields Eye Hospital, London, EC1V 2PD, UK; david.charteris{at}moorfields.nhs.uk

Abstract

Aim: To evaluate the efficacy of pars plana vitrectomy (PPV) in the management of chronic uveitic cystoid macular oedema (CMO).

Methods: A prospective, interventional, randomised, controlled, pilot study. 23 eyes of 23 patients with CMO secondary to chronic intermediate or posterior uveitis unresponsive to medical treatment were randomised into a surgical (group S) or medical group (group M). 12 patients in group S underwent PPV as opposed to 11 patients in group M who received systemic corticosteroid and/or immunosuppressive treatment during the study period. The primary outcome measures of the study were change in visual acuity and angiographic appearance of CMO at 6 months.

Results: Mean visual acuity in group S improved significantly from 1.0 (0.62) at baseline to 0.55 (0.29) at 6 months following vitrectomy (p = 0.011), with five (42%) eyes reaching vision of 20/40 or better. Conversely, mean visual acuity in group M improved only marginally by 0.03 (0.27) (p = 0.785). CMO after vitrectomy was angiographically improved in four (33%) eyes, remained unchanged in seven (58%) eyes, and deteriorated in one (8%) eye. In the medical group, fluorescein leakage decreased in one eye, did not alter in four eyes, and deteriorated in two eyes.

Conclusion: PPV for macular oedema secondary to chronic uveitis despite angiographic improvement in only one third of the patients, seems to have a significant beneficial effect on visual function. This study provides enough evidence to justify a large scale trial which would define the role of vitrectomy in uveitic macular oedema.

  • CMO, cystoid macular oedema
  • FFA, fundus fluorescein angiogram
  • PPV, pars plana vitrectomy
  • pars plana vitrectomy
  • cystoid macular oedema
  • uveitis
  • pilot study
  • CMO, cystoid macular oedema
  • FFA, fundus fluorescein angiogram
  • PPV, pars plana vitrectomy
  • pars plana vitrectomy
  • cystoid macular oedema
  • uveitis
  • pilot study

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Footnotes

  • Financial interest: none.

  • The study was approved by the local research ethics committee at Moorfields Eye Hospital, London.

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