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Central subfield thickness changes and factors associated with OCT-confirmed cystoid macular edema after slow-coagulation transscleral cyclophotocoagulation for glaucoma.
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Hosny Rawan, Alshunnar Moawiya S, Khodeiry Mohamed M, Lee Richard K, Sayed Mohamed S
Аннотация
PURPOSE: To quantify serial central subfield thickness (CSFT) changes after slow-coagulation transscleral cyclophotocoagulation (SC-TSCPC) for glaucoma, estimate the incidence of OCT-confirmed cystoid macular edema (CME), and explore baseline factors associated with CME, including diabetes and prior diabetic macular edema.
METHODS: Retrospective cohort of 31 eyes undergoing SC-TSCPC for glaucoma with OCT imaging preoperatively and postoperatively at 1, 3, 6, 9, and 12 months and at last follow-up (range 9-30 months). OCT-confirmed CME was defined as cystoid intraretinal changes on OCT; increased CSFT alone was not classified as CME. Changes over time were assessed with non-parametric repeated-measures testing, and subgroup comparisons were exploratory and univariate because of the small sample size.
RESULTS: Mean baseline CSFT was 279 ± 25 um and peaked at 355 ± 153 um at 1 month, then declined to 293 ± 25 um at 12 months (p < 0.001 across visits). Mean CSFT at last follow-up remained higher than baseline (294 ± 25 vs. 279 ± 25 um; p < 0.001). OCT-confirmed CME developed in 8/31 eyes (25.8%), first detected at 1-6 months (mean 2.1 ± 1.8). Eyes that developed OCT-confirmed CME had higher preoperative CSFT than eyes without CME (311 ± 21 vs. 267 ± 15 um; p < 0.001). In exploratory univariate analyses, OCT-confirmed CME occurred more frequently in eyes with diabetes mellitus (p = 0.031) and prior diabetic macular edema (p < 0.001). Mean intraocular pressure decreased from 36.1 ± 9.0 to 15.2 ± 3.6 mmHg at 12 months (p < 0.001). Mean corrected distance visual acuity (CDVA) changed from 0.90 ± 0.90 logMAR preoperatively to 1.02 ± 0.85 logMAR at last follow-up (p = 0.004), and CDVA at last follow-up did not differ between eyes with and without OCT-confirmed CME (p = 0.992).
CONCLUSION: SC-TSCPC was associated with a transient postoperative increase in CSFT and a clinically relevant incidence of OCT-confirmed CME. In this small retrospective cohort, higher preoperative CSFT and diabetes-related retinal disease identified a subgroup with greater observed CME frequency, but these findings should be interpreted as exploratory associations rather than independent risk factors. Postoperative OCT surveillance may help identify early anatomic edema, particularly in higher-risk eyes.
METHODS: Retrospective cohort of 31 eyes undergoing SC-TSCPC for glaucoma with OCT imaging preoperatively and postoperatively at 1, 3, 6, 9, and 12 months and at last follow-up (range 9-30 months). OCT-confirmed CME was defined as cystoid intraretinal changes on OCT; increased CSFT alone was not classified as CME. Changes over time were assessed with non-parametric repeated-measures testing, and subgroup comparisons were exploratory and univariate because of the small sample size.
RESULTS: Mean baseline CSFT was 279 ± 25 um and peaked at 355 ± 153 um at 1 month, then declined to 293 ± 25 um at 12 months (p < 0.001 across visits). Mean CSFT at last follow-up remained higher than baseline (294 ± 25 vs. 279 ± 25 um; p < 0.001). OCT-confirmed CME developed in 8/31 eyes (25.8%), first detected at 1-6 months (mean 2.1 ± 1.8). Eyes that developed OCT-confirmed CME had higher preoperative CSFT than eyes without CME (311 ± 21 vs. 267 ± 15 um; p < 0.001). In exploratory univariate analyses, OCT-confirmed CME occurred more frequently in eyes with diabetes mellitus (p = 0.031) and prior diabetic macular edema (p < 0.001). Mean intraocular pressure decreased from 36.1 ± 9.0 to 15.2 ± 3.6 mmHg at 12 months (p < 0.001). Mean corrected distance visual acuity (CDVA) changed from 0.90 ± 0.90 logMAR preoperatively to 1.02 ± 0.85 logMAR at last follow-up (p = 0.004), and CDVA at last follow-up did not differ between eyes with and without OCT-confirmed CME (p = 0.992).
CONCLUSION: SC-TSCPC was associated with a transient postoperative increase in CSFT and a clinically relevant incidence of OCT-confirmed CME. In this small retrospective cohort, higher preoperative CSFT and diabetes-related retinal disease identified a subgroup with greater observed CME frequency, but these findings should be interpreted as exploratory associations rather than independent risk factors. Postoperative OCT surveillance may help identify early anatomic edema, particularly in higher-risk eyes.