Risk factors analysis of cystoid macular edema in patients with anterior uveitis

Background Cystoid macular edema (CME) is one of common causes of significant visual loss in the patients with uveitis,especially in the patients with panuveitis,intermediate uveitis and posterior uveitis.Objective Present study was to determine the frequency and ophthalmologic or systemic factors associated with the presence of CME in patients with anterior uveitis.Methods Retrospective cross-sectional design was performed for the analysis of the 108 consecutive patients with anterior uveitis from January 2007 to February 2009 in Tianjin Eye Hospital.The extensive questionnaire for the presence of systemic diseases and ocular risk factors were collected in the all patients.The CME was determined by fundus fluorescent angiography (FFA) or by optical coherence tomography (OCT).The eyes of anterior uveitis combined with intermediate or posterior uveitis were excluded.The laboratory examinations associated with uveitis were evaluated.Results Among the 129 eyes of 108 patients with anterior uveitis,the unilateral attacks was 87 cases,and the bilateral attacks was 21 cases.Forty-three eyes from 41 cases appeared CME with the prevalence of 33.3%.The initial average corrected acuity in CME eyes was 0.41±0.16 and that without CME was 0.56±0.13,showing a significant difference between them (q=5.040,P=0.000),but the final average acuity in the patients of both groups were not significantly different (0.82±0.18 versus 0.85±0.14) (q=1.130,P=0.260).The multivariate logistic regression analysis showed the significant association between the onset of CME and relapsed history frequently (P=0.017,OR=7.62,95%CI:1.44-40.23),HLA-B27 positive response (P=0.049,OR=3.93,95%CI:1.01-15.30),vitreous cells (P=0.023,OR=3.46,95%CI:1.19-10.04),older age (P=0.001,OR=1.090,95%CI:1.04-1.15) and the lower initial visual acuity (P=0.007,OR=0.01,95%CI:0.00-0.25).The gender(P=0.090,OR=0.39,95%CI:0.13-1.16),systemic hypertensions(P=0.960,OR=1.04,95%CI:0.32-3.35) or diabetic mellitus history (P=0.510,OR=1.57,95%CI:0.41-6.06),juvenile arthritis(P=0.470,OR=2.61,95%CI:0.19-35.27) and the final visual acuity (P=0.870,OR=0.73,95%CI:0.02-30.20) were not correlated with the onset of CME.Conclusion The frequent relapsed history,HLA-B27 positive response,vitreous cells and the older age are the risk factors for the onset of CME in patients with anterior uveitis.Good visual prognosis can be achieved following the proper management in majority of the eyes with CME and anterior uveitis.