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Decreased Visual Acuity Associated With Cystoid Macular Edema in Neovascular Age-related Macular Degeneration
T. Daniel Ting, MD, PhD;
Mila Oh, MD;
Terry A. Cox, MD, PhD;
Carsten H. Meyer, MD;
Cynthia A. Toth, MD
Arch Ophthalmol. 2002;120:731-737.
Objective To determine the prevalence and visual significance of cystoid macular
edema (CME) in eyes with subfoveal neovascular age-related macular degeneration
using optical coherence tomography (OCT).
Materials and Methods The medical records of 61 consecutive patients initially seen with nondisciform
subfoveal neovascular age-related macular degeneration were retrospectively
reviewed. All patients underwent fluorescein angiography and OCT imaging.
Eyes with intraretinal hyporeflective spaces in the macula in the OCT images
were considered to have CME.
Results Twenty-eight (46%) of 61 eyes demonstrated CME on the OCT images. The
presence of CME and increased foveal thickness correlated with decreased visual
acuity, but not with the duration of symptoms. Twenty-six (93%) of 28 eyes
with CME contained classic choroidal neovascularization, whereas 16 (48%)
of 33 eyes without CME contained classic choroidal neovascularization.
Conclusions Cystoid macular edema is a common finding in patients with choroidal
neovascularization associated with age-related macular degeneration. The presence
of CME and foveal thickening is associated with worse visual acuity in these
patients. Cystoid macular edema is more common with choroidal neovascularization
containing classic component. The OCT is a useful test to detect the presence
of CME in these patients since CME may be difficult to identify on fluorescein
angiogram.
From the Departments of Ophthalmology (Drs Ting, Oh, Cox, Meyer, and
Toth) and Biostatistics and Bioinformatics (Dr Cox), Duke University Medical
Center, Durham, NC. The authors have no commerical, proprietary, or financial
interest in the products or companies described in this article.
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