Mohankumar, A (2007) Role of optical coherence tomography in management of post operative cystoid macular edema. Masters thesis, Institute of Ophthalmology, Joseph Eye Hospital, Tiruchirapalli.
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Abstract
INTRODUCTION: High resolution cross sectional imaging of the retina is useful for identifying, monitoring and quantitatively assessing macular diseases. Optical Coherence Tomography (OCT) is a new medical diagnostic imaging technology which can perform micron resolution, cross sectional or tomographic imaging in biological tissues. Cross sectional images of the retina are obtained at the resolution of 10 microns. OCT uses low coherence or white light interferometry to perform high resolution measurements and imaging. The infra red light beam has a wavelength of 820 nm. Post Operative Cystoid Macular Edema (CME) frequently occurs following cataract surgery. It can also occur following YAG capsulotomy, Cryo, Laser photocoagulation, scleral buckling and Penetrating Keratoplasty (PKP). Cystoid macular edema is the result of accumulation of fluid in the outer plexiform and inner nuclear layers of the retina centrered about the foveala and formation of fluid filled cyst like changes. OCT offers an objective test for quantitative evaluation of patients with CME. OCT can quantitatively assess retinal thickness and demonstrate any associated RPE structural anomalies beneath edematous retina which can be obscured by leakage on angiography. Measurement of retinal thickness by OCT correlate more strongly with visual acuity than presence of leakage on angiography. The aim of the present dissertation is to study optical coherence tomographic features in post operative CME and monitor it with OCT. AIM OF THE STUDY: 1. To study the optical coherence tomography features of post operative CME. 2. To assess the role of optical coherence tomography in monitoring, diagnosis and followup of cystoid macular edema. PATIENTS AND METHODS: Patients with Clinical diagnosis of CME who presented to the Retina Clinic of Institute of Ophthalmology, Joseph Eye Hospital, Trichy between May 1st 2005 to April 30, 2006, were included in this study. Inclusion Criteria Inclusion criteria were all patients with clinical diagnosis of CME > 4 weeks following ocular surgery. Exlusion Criteria • CME due to other causes including Diabetic retinopathy, Branch Retinal Vein Occlusion, Central Retinal Vein Occlusion, Uveitis • Patients who did not complete minimum followup period of 3 months. A standard protocol was used to collect and document all the details regarding the cases included in this study. A detailed information about history and complaints of the patients were taken. This included o Type / date of surgery o Complications of surgery o Chief complaints o Duration of symptoms RESULTS: The demographical data includes age, sex of the patients, laterality, type of surgery, duration of problem, pretreatment and post treatment BCVA, macular thickness. The minimum follow up period was 6 months. Patients included in this study were subjected to FFA, OCT at the time of presentation and also at first and second review after 1 and 2 months respectively. DISCUSSION: Optical coherence tomography is a noninvasive, non contact imaging system that uses superluminescent diode light source to create high resolution, real time, cross sectional tomographic images of retina. In our study it was used in 20 patients with post operative CME. Clinical findings in CME may be subtle without matching with visual acuity. OCT can play an important role in these eyes. OCT can also prove useful for objective followup in these cases. In our study, the maximum number of patients were between 51 – 60 years age group (Mean 61.85 years) which was similar to the study done by Jalementel65 and associates (Avg. 69.883). In our study males were more compared with females (4 : 1). Williamson et al. in their study have mentioned the sex ratio to be 1.2 : 1. The main risk factors for development of CME in our study were PC rent, vitreous loss, AC IOL, ECCE. Tina A et al. in their study have mentioned ruptured PC, ECCE, retained lens fragments, vitreous loss, iris trauma, AC IOL, Post uveitis as major risk factors. SUMMARY: In this prospective, non comparative study, 20 eyes of 20 patients with post operative cystoid macular edema were included. FFA was done for all the patients. Optical coherence was done to all patients at presentation and during follow up. OCT was used to quantitatively assess retinal thickness and demonstrate any associated RPE structural anomalies beneath the oedematous retina, which can be obscured by leakage on angiography. Line scan was done through the leak site.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | optical coherence tomography; management; post operative cystoid macular edema |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Devi S |
| Date Deposited: | 22 Dec 2017 11:32 |
| Last Modified: | 22 Dec 2017 11:32 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/4717 |
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