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Değirmenci MFK, Yalçındağ FN, İdil ŞA. Evaluation and comparison of microperimetry and optical coherence tomography findings in patients with Behçet uveitis. Int Ophthalmol 2024; 44:23. [PMID: 38324174 DOI: 10.1007/s10792-024-02928-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 12/17/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE To evaluate and compare the findings of MP and OCT in patients with inactive Behçet's uveitis (BU). METHODS Sixty-five eyes of 38 patients were included in this retrospective study. Ophthalmologic examination findings and OCT and MP results were recorded. The relationship between best corrected visual acuity (BCVA), duration of uveitis, central macular thickness (CMT), presence of photoreceptor zone (PZ), and/or retinal pigment epithelium (RPE) damage, macular integrity index, mean threshold and fixation stability was analyzed. RESULTS There was a positive correlation between BCVA and CMT (p < 0.001). The eyes with PZ and/or RPE damage had significantly lower visual acuity (p < 0.001). There was a negative correlation between BCVA and macular integrity index (p = 0.005). BCVA showed positive correlations with mean threshold and fixation stability [(BCVA vs. mean threshold, p < 0.001), (BCVA vs. P1, p < 0.001), and (BCVA vs. P2, p < 0.001)]. While there was no significant correlation between CMT and macular integrity index (p = 0.08), both mean threshold and fixation stability were significantly positively correlated with CMT [(CMT vs. mean threshold, p = 0.01), (CMT vs. P1, p = 0.008), and (CMT vs. P2, p = 0.005)]. Mean threshold and fixation stability (P1 and P2) were significantly lower in the eyes with PZ and/or RPE damage (p = 0.008, p = 0.02, and p = 0.01, respectively). CONCLUSION MP showed results consistent with visual acuity and morphological findings by OCT in patients with inactive BU. Although MP is promising for patient follow-up, controlled prospective studies are needed.
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Affiliation(s)
| | - F Nilüfer Yalçındağ
- Department of Ophthalmology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ş Aysun İdil
- Department of Ophthalmology, Faculty of Medicine, Ankara University, Ankara, Turkey
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Khochtali S, Tugal-Tutkun I, Fardeau C, Maestri F, Khairallah M. Multimodality Approach to the Diagnosis and Assessment of Uveitic Macular Edema. Ocul Immunol Inflamm 2020; 28:1212-1222. [DOI: 10.1080/09273948.2020.1797112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Sana Khochtali
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Christine Fardeau
- Ophthalmology Department, Reference Centre for Rare Diseases, Pitié-Salpétrière Hospital, University Paris VI, DHU Sight Restore, Paris, France
| | - Federico Maestri
- Ophthalmology Department, Reference Centre for Rare Diseases, Pitié-Salpétrière Hospital, University Paris VI, DHU Sight Restore, Paris, France
| | - Moncef Khairallah
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
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Ceklic L, Huf W, Ebneter A, Wolf S, Zinkernagel MS, Munk MR. The impact of ganglion cell layer cysts in diabetic macular oedema treated with anti-vascular endothelial growth factor. Acta Ophthalmol 2019; 97:e1041-e1047. [PMID: 31099498 DOI: 10.1111/aos.14137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 04/18/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE To investigate the prevalence and impact of ganglion cell layer cysts (GCLC) in patients with diabetic macular oedema (DME) under continuous anti-vascular endothelial growth factor (VEGF) therapy. METHODS The clinical findings and spectral domain optical coherence devices of baseline visits and follow-up after 12-24 and 36 months of DME patients under continuous anti-VEGF therapy were retrospectively collected and analysed for the impact of GCLC cysts. Previously established prognostic parameters were also assessed. RESULTS A total of 110 eyes of 110 DME patients (mean age 64 ± 10 years) were included. At baseline, 17% eyes had GCLC. With GCLC, the best-corrected visual acuity (BCVA) improvement was in mean 8.4 ± 2.4 Early-Treatment-Diabetic-Retinopathy-Study (ETDRS) letters less over the course of 36 months compared to the group lacking GCLC (p = 0.0009). Eyes with GCLC showed 68 ± 23.4 μm less central retinal thickness (CRT) decrease than eyes lacking GCLC (p < 0.0001). In the linear mixed effect models including external limiting membrane disruption, disintegration of inner retinal layer and epiretinal membrane, GCLC remained a statistical significant factor for the outcome parameter CRT, but missed statistical significance for BCVA. CONCLUSION Ganglion cell layer cysts (GCLC) seem to impact outcome in DME in patients receiving long-term treatment. This prognostic factor warrants further evaluation in the context of already well-established outcome parameters.
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Affiliation(s)
- Lala Ceklic
- Department of Ophthalmology, Inselspital Bern University Hospital University of Bern Bern Switzerland
- Bern Photographic Reading Center University Hospital Bern Bern Switzerland
| | - Wolfgang Huf
- Karl Landsteiner Institute for Clinical Risk Management Vienna Austria
| | - Andreas Ebneter
- Department of Ophthalmology, Inselspital Bern University Hospital University of Bern Bern Switzerland
| | - Sebastian Wolf
- Department of Ophthalmology, Inselspital Bern University Hospital University of Bern Bern Switzerland
- Bern Photographic Reading Center University Hospital Bern Bern Switzerland
| | - Martin S. Zinkernagel
- Department of Ophthalmology, Inselspital Bern University Hospital University of Bern Bern Switzerland
- Bern Photographic Reading Center University Hospital Bern Bern Switzerland
| | - Marion R. Munk
- Department of Ophthalmology, Inselspital Bern University Hospital University of Bern Bern Switzerland
- Bern Photographic Reading Center University Hospital Bern Bern Switzerland
- Department of Ophthalmology Northwestern University Feinberg School of Medicine Chicago Illinois USA
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Sborgia G, Niro A, Sborgia A, Albano V, Tritto T, Sborgia L, Pastore V, Donghia R, Giancipoli E, Recchimurzo N, Boscia F, Alessio G. Inverted internal limiting membrane-flap technique for large macular hole: a microperimetric study. Int J Retina Vitreous 2019; 5:44. [PMID: 31641530 PMCID: PMC6798391 DOI: 10.1186/s40942-019-0195-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/10/2019] [Indexed: 02/02/2023] Open
Abstract
Background Inverted Internal Limiting Membrane (ILM)-flap technique would seem to lead to higher closure rate and better visual acuity than traditional procedure with ILM peeling for the treatment of large macular hole (LMH). Visual acuity recovery does not reveal many other functional changes related to surgical approach. Our purpose was to evaluate macular function and morphology over a 1-year follow-up after inverted ILM-flap technique for LMH by using microperimetry in order to predict visual prognosis. Methods This study was a prospective unrandomized single-center study. 23 eyes of 22 patients with idiopathic LMH, with a minimum diameter ranging from 400 to 1000 μm, were included. All patients underwent vitrectomy with inverted ILM-flap technique and gas tamponade. We analyzed macular hole closure rate and functional outcomes including best-corrected visual acuity (BCVA), macular sensitivity (MS) at central 12° and central macular sensitivity (CMS) at central 4°, and fixation behavior as bivariate contour ellipse area (BCEA, degrees2) at 68%, 95%, and 99% of fixation points measured by microperimeter, over a follow-up of 12 months. Results The macular hole closure rate was 98%. The BCVA improved from 20/230 (Logmar, 1.06 ± 0.34) to 20/59 (logMar, 0.47 ± 0.45) at last follow-up (p < 0.001). Retinal sensitivity and BCEA significantly improved (MS, p = 0.001; CMS, p < 0.0001; BCEA: 68%, p < 0.01; 95%, p < 0.01; 99%, p = 0.001). Multiple stepwise regression analysis showed the final BCVA was significantly associated with macular hole size (β = 0.002, p = 0.03), preoperative MS (β = − 0.06, p = 0.001) and BCEA at 95% and 99% of fixation points (β = − 0.12, p = 0.01; β = 0.06, p = 0.01). Conclusions Inverted ILM-flap technique for LMH results in good morphologic and functional outcomes. Macular hole size and microperimetric parameters as preoperative MS and BCEA have a predictive role on post-surgical visual acuity.
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Affiliation(s)
- Giancarlo Sborgia
- 1Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Alfredo Niro
- Eye Clinic, Hospital "S. G. MOSCATI", ASL TA, Via Per Martina Franca, 74010 Statte, Taranto Italy
| | - Alessandra Sborgia
- 1Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy.,Eye Clinic, Hospital "S. G. MOSCATI", ASL TA, Via Per Martina Franca, 74010 Statte, Taranto Italy
| | - Valeria Albano
- 1Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Tiziana Tritto
- 1Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Luigi Sborgia
- 1Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Valentina Pastore
- 1Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Rossella Donghia
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Ermete Giancipoli
- 4Department of Surgical, Microsurgical and Medical Sciences, Eye Clinic, University of Sassari, Sassari, Italy
| | - Nicola Recchimurzo
- 1Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Francesco Boscia
- 4Department of Surgical, Microsurgical and Medical Sciences, Eye Clinic, University of Sassari, Sassari, Italy
| | - Giovanni Alessio
- 1Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy
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Analysis of Morphologic and Functional Outcomes in Macular Edema due to Central Retinal Vein Occlusion Treated with Intravitreal Dexamethasone Implant. J Ophthalmol 2018; 2018:5604632. [PMID: 30271628 PMCID: PMC6151240 DOI: 10.1155/2018/5604632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/11/2018] [Indexed: 12/03/2022] Open
Abstract
Purpose To analyze anatomic and functional retinal changes and their correlation after intravitreal dexamethasone implant (DEX implant) in patients with central retinal vein occlusion- (CRVO-) related macular edema (ME) using optical coherence tomography and microperimetry. Methods Fifteen treatment-naïve patients with functional impairment due to CRVO-related ME were enrolled in this prospective interventional case series. Main outcomes were best-corrected visual acuity (BCVA), retinal sensitivity (RS), and central retinal thickness (CRT). Secondary outcomes were ellipsoid zone (EZ) status and fixation behaviour. All patients underwent DEX implant and were retreated according to predefined criteria. Data were prospectively recorded at baseline and at month 1, 3, 6, 9, and 12. Correlation between main outcomes was analyzed. Results Fifteen eyes of 15 patients (9 men, 6 women; mean age 61.8 ± 10.9 years) were included. BCVA and CRT significantly improved at all follow-up visits, while RS significantly improved at 3, 6, 9, and 12 months. EZ status and fixation behaviour did not change significantly. Baseline CRT had a significant negative correlation with BCVA and RS at different follow-up visits (r=−0.52 to −0.63, p ≤ 0.04; r=−0.52, p=0.04; resp.). At all time points, there was not a significant correlation between CRT and BCVA and RS, while RS and BCVA showed a significant correlation, increasing over time (r=−0.72 to −0.89; p < 0.001). Conclusion DEX implant led to a significant morphofunctional improvement. Baseline CRT is predictive of changes of functional outcomes whose correlation increases over time after treatment.
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Laishram M, Srikanth K, Rajalakshmi AR, Nagarajan S, Ezhumalai G. Microperimetry - A New Tool for Assessing Retinal Sensitivity in Macular Diseases. J Clin Diagn Res 2017; 11:NC08-NC11. [PMID: 28892948 DOI: 10.7860/jcdr/2017/25799.10213] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 06/08/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Macular disease is the leading cause of low vision in the Western world. Drusen and pigmentary irregularities are common among the rural Northern Indian population. The disease process leads to loss of central vision, metamorphopsia, macropsia or micropsia and colour vision defect. AIM To study the retinal sensitivity changes in macular diseases using microperimetry. MATERIALS AND METHODS It was an observational study, conducted in the Department of Ophthalmology at a rural tertiary care hospital. This study was started from December 2014 until June 2016, in all patients with macular disease above the age of 20 years attending the outpatient department. Microperimetry was done for 84 eyes of 52 patients with macular disease. Mean retinal Sensitivity (MS) and fixation stability was evaluated. The statistical analysis of mean retinal sensitivity, central 2° and 4° fixation was done by calculating the mean and standard deviation using 95% confidence interval. RESULTS The range of age was between 20-81 years. Majority were 32 males (62%) and 20 females (38%). Out of the 84 eyes studied, majority of the macular disease were Age-Related Macular Degeneration (AMD) (50%). Rest 50% were other macular diseases. The mean retinal sensitivity (dB) shown by microperimetry was 10.83 in AMD, 9.12 in Cystoid Macular Oedema (CME), 10.34 in Epiretinal Membrane (ERM), 10.74 in Pigment Epithelial Detachment (PED), 8.96 in Central Serous Chorioretinopathy (CSCR), 6.43 in macular dystrophy, 7.15 in Lamellar Hole (LMH), 9.8 in Pseudomacular Hole (PMH), 3 in geographic atrophy, 11.1 in macular telangiectasia, 5.6 in Berlin oedema, 12.3 in macular scar and 15.2 in haemorrhage in macula. The study showed 64% of the eyes had stable 2° central fixation, 35% had relatively unstable fixation and 1% had unstable fixation. No significant correlation between retinal sensitivity and retinal thickness in AMD was found. CONCLUSION This study shows that microperimetry can be a useful tool for objective evaluation of macular function and progression of the disease.
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Affiliation(s)
- Memota Laishram
- Resident, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Krishnagopal Srikanth
- Professor and Head, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - A R Rajalakshmi
- Associate Professor, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Swathi Nagarajan
- Assistant Professor, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - G Ezhumalai
- Senior Statistician, Department of Statistics, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
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Munk MR, Ram R, Rademaker A, Liu D, Setlur V, Chau F, Schmidt-Erfurth U, Goldstein DA. Influence of the vitreomacular interface on the efficacy of intravitreal therapy for uveitis-associated cystoid macular oedema. Acta Ophthalmol 2015; 93:e561-7. [PMID: 25708777 DOI: 10.1111/aos.12699] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 01/12/2015] [Indexed: 01/31/2023]
Abstract
PURPOSE To evaluate the effect of the vitreomacular interface (VMI) on treatment efficacy of intravitreal therapy in uveitic cystoid macular oedema (CME). METHODS Retrospective analysis of CME resolution, CME recurrence rate and monthly course of central retinal thickness (CRT), retinal volume (RV) and best corrected visual acuity (BCVA) after intravitreal injection with respect to the VMI configuration on spectral-domain OCT using chi-squared test and repeated measures anova adjusted for confounding covariates epiretinal membrane, administered drug and subretinal fluid. RESULTS Fifty-nine eyes of 53 patients (mean age: 47.4 ± 16.9 years) were included. VMI status had no effect on complete CME resolution rate (p = 0.16, corrected p-value: 0.32), time until resolution (p = 0.09, corrected p-value: 0.27) or CME relapse rate (p = 0.29, corrected p-value: 0.29). Change over time did not differ among the VMI configuration groups for BVCA (p = 0.82) and RV (p = 0.18), but CRT decrease was greater and faster in the posterior vitreous detachment (PVD) group compared to the posterior vitreous attachment (PVA) and vitreous macular adhesion (VMA) groups (p = 0.04). Also, the percentage of patients experiencing a ≥ 20% CRT thickness decrease after intravitreal injection was greater in the PVD group (83%) compared to the VMA (64%) and the PVA (16%) group (p = 0.027), however, not after correction for multiple testing (corrected p-value: 0.11). CONCLUSION The VMI configuration seems to be a factor contributing to treatment efficacy in uveitic CME in terms of CRT decrease, although BCVA outcome did not differ according to VMI status.
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Affiliation(s)
- Marion R. Munk
- Department of Ophthalmology; Feinberg School of Medicine; Northwestern University; Chicago IL USA
- Department of Ophthalmology; Medical University Vienna; Vienna Austria
- Department of Ophthalmology; Inselspital; University Hospital Bern; Bern Switzerland
| | - Radha Ram
- Department of Ophthalmology; Feinberg School of Medicine; Northwestern University; Chicago IL USA
| | - Alfred Rademaker
- Biostatistics Collaboration Center; Feinberg School of Medicine; Northwestern University; Chicago IL USA
| | - Dachao Liu
- Biostatistics Collaboration Center; Feinberg School of Medicine; Northwestern University; Chicago IL USA
| | - Vikram Setlur
- Department of Ophthalmology; University of Illinois; Eye and Ear Infirmary; Chicago IL USA
| | - Felix Chau
- Department of Ophthalmology; University of Illinois; Eye and Ear Infirmary; Chicago IL USA
| | | | - Debra A. Goldstein
- Department of Ophthalmology; Feinberg School of Medicine; Northwestern University; Chicago IL USA
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Kim DY, Yang HS, Kook YJ, Lee JY. Association between microperimetric parameters and optical coherent tomographic findings in various macular diseases. KOREAN JOURNAL OF OPHTHALMOLOGY 2015; 29:92-101. [PMID: 25829825 PMCID: PMC4369523 DOI: 10.3341/kjo.2015.29.2.92] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/07/2014] [Indexed: 11/23/2022] Open
Abstract
Purpose To analyze the correlation between microperimetric parameters and optical coherent tomographic findings in the eyes of patients with macular diseases. Methods A total of 64 eyes were included in this retrospective cross-sectional study. Differences in the macular integrity index and microperimetric parameters were analyzed according to types of outer retinal band defects. Correlations between average threshold values and retinal thickness in the corresponding areas were analyzed. Finally, microperimetric parameters were compared between inner and outer retinal lesions. Results Measures of best-corrected visual acuity, macular integrity index, and average threshold values were significantly worse in eyes with defects in the ellipsoid portion of the photoreceptor inner segment (ISe), the cone outer segment tip (COST), and the external limiting membrane (ELM) than in eyes without ISe, COST, and ELM defects. Also, visual functionality is more significantly impacted by ELM defects than by other hyper-reflective band defects. There was a significant negative correlation between retinal thickness and the average threshold of the corresponding area in the Early Treatment Diabetic Retinopathy Study grid. Microperimetric parameters in the eyes of patients with inner retinal lesions were better than in the eyes of patients with outer retinal lesions. Conclusions The macular integrity index may be a useful factor for reflecting the functional aspects of macular diseases. Specifically, ELM, ISe, and COST defects are significantly associated with poor retinal sensitivity and macular integrity index values that suggest abnormalities. Among eyes with these particular defects, the visual functionality of patients is most sensitively impacted by ELM defects. This finding suggests that microperimetric parameters are sensitive and useful for evaluating functional abnormalities in the eyes of patients with macular disease, particularly in patients with outer retinal pathology.
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Affiliation(s)
- Dong Yoon Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Seung Yang
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Yoon Jun Kook
- University of Ulsan College of Medicine, Seoul, Korea
| | - Joo Yong Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Munk MR, Dunavoelgyi R, Baratsits M, Matt G, Montuoro A, Buehl W, Schmidt-Erfurth U, Sacu S. Detection and Differentiation of Intraretinal Hemorrhage in Spectral Domain Optical Coherence Tomography. Curr Eye Res 2014; 40:1046-54. [DOI: 10.3109/02713683.2014.971931] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Systematic correlation of morphologic alterations and retinal function in eyes with uveitis-associated cystoid macular oedema during development, resolution and relapse. Br J Ophthalmol 2013; 97:1289-96. [DOI: 10.1136/bjophthalmol-2012-303052] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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