Disorganization of the retinal inner layers as a predictor of visual acuity in eyes with macular edema secondary to uveitis

AIM:To assess the correlation between disorganization of the retinal inner layers(DRIL)and best-corrected visual acuity(BCVA)in patients with uveitis and macular edema(UME)who underwent systemic treatment using optical coherence tomography(OCT).METHODS:A retrospective clinical study of 23 patients(30 eyes)with DRIL and 23 patients(31 eyes)without DRIL secondary to UME were included.All patients underwent comprehensive ophthalmic examinations at baseline,3,6,and 12 mo after local and systemic treatment.The OCTbased parameters included foveal center point thickness(FCPT),mean thickness(MT),and diameters of DRIL in horizontal and vertical directions.BCVA and OCT-based parameters were compared between the two groups.The relationship between each OCT parameter and BCVA was evaluated using linear correlation and regression analysis.RESULTS:At the initial visit,the mean baseline FCPT was 441.03±128.68μm in the eyes with DRIL and 337.26±99.31μm in the eyes without DRIL(P=0.001).No significant differences were observed in MT(P=0.357).The mean size of transverse and vertical diameters of DRIL was 684.07±267.51 and 267.07±104.61μm at baseline,respectively.There was significant improvement in BCVA and OCT-based parameters at 3,6,and 12 mo in all cases(P<0.001 for each timepoint).In addition,significant differences were detected in BCVA and OCT parameters between eyes with and without DRIL at each time point(P<0.01 for each timepoint).A greater DRIL range at baseline was associated with a worse baseline BCVA(transverse diameter of DRIL:r=0.875,P<0.001;vertical diameter of DRIL:r=0.622,P<0.001).The transverse diameter of baseline DRIL was found to be significantly correlated with the final BCVA(P=0.003).CONCLUSION:The improvement in BCVA is associated with DRIL in patients with UME.DRIL is an easy-todetermine and robust imaging biomarker that could help predict BCVA prognosis in eyes with UME.