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2016 ; 6
(1
): 33
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Morphological assessment of the retina in uveitis
#MMPMID27613274
Altaweel MM
; Gangaputra SS
; Thorne JE
; Dunn JP
; Elner SG
; Jaffe GJ
; Kim RY
; Rao PK
; Reed SB
; Kempen JH
J Ophthalmic Inflamm Infect
2016[Dec]; 6
(1
): 33
PMID27613274
show ga
BACKGROUND: The objective of this study is to describe a system for color
photograph evaluation in uveitis and report baseline morphologic findings for the
Multicenter Uveitis Steroid Treatment (MUST) Trial. Four-hundred seventy-nine
eyes of 255 subjects with intermediate, posterior, and panuveitis had
stereoscopic color fundus photographs obtained by certified photographers and
evaluated by certified graders using standardized procedures to evaluate
morphologic characteristics of uveitis. The posterior pole was evaluated for
macular edema, vitreoretinal interface abnormalities, and macular pigment
disturbance/atrophy; the optic disk was assessed for edema, pallor, or
glaucomatous changes. The presence of neovascularization, vascular occlusion,
vascular sheathing, and tractional retinal changes was determined. A random
subset of 77 images was re-graded to determine the percentage agreement with the
original grading on a categorical scale. RESULTS: At baseline, 437/479 eyes had
images available to grade. Fifty-three eyes were completely ungradable due to
media opacity. Common features of intermediate and posterior/panuveitis were
epiretinal membrane (134 eyes, 35 %), and chorioretinal lesions (140 eyes, 36 %).
Macular edema was seen in 16 %. Optic nerve head and vascular abnormalities were
rare. Reproducibility evaluation found exact agreement for the presence of
chorioretinal lesions was 78 %, the presence and location of macular edema was
71 %, and the presence of epiretinal membrane was 71 %. Vertical cup-to-disk
ratio measurement had intra-class correlation of 0.75. CONCLUSIONS: The MUST
system for evaluating stereoscopic color fundus photographs describes the
morphology of uveitis and its sequelae, in a standardized manner, is highly
reproducible, and allows monitoring of treatment effect and safety evaluation
regarding these outcomes in clinical trials.