D.CHIN1, M.TIEN2, N.GAN2, S.L.HO2, Z.X.THNG2, G.E.HOLDER3, R.AGRAWAL2
MOH Holdings Pte Ltd (MOHH)1, Tan Tock Seng Hospital2, National University Hospital3
Patients with uveitis encompass a wide range of conditions that can present a diagnostic and management challenge for clinicians. They often require multi-modal imaging and assessment in order to get an accurate diagnosis for initiation of treatment. In this study, we aim to look at the application of electrophysiology and evaluating structure-functional relationship in clinical management of posterior uveitis.
Single center retrospective observational study. Chart review of patients with diagnosis of posterior uveitis from uveitis or medical retina clinic at a tertiary referral eye care centre in Singapore.
A total of 20 (8 male, 12 female) cases with mean age of 53 (27-86) years with diagnosis of posterior uveitis encompassing autoimmune retinopathy, infective uveitis, acute zonal occult outer retinopathy (AZOOR) and retinal vasculitis were reviewed. 7 patients had symptoms of blurring of vision (35%) 6 had photopsia (30%) 3 had scotomas (15%) 2 had floaters (10%), 1 had photophobia (5%) and 3 were asymptomatic (15%) at presentation.
Clinically significant structural changes in optical coherence tomography were present in 15 patients (75%), of which 13 patients had disruptions in the ellipsoid zone (65%). 5 patients with no significant OCT findings demonstrated significant electrophysiological findings, of which 3 were helpful in making a clinical diagnosis. In all, electrophysiology testing assisted in providing a specific clinical diagnosis in 14 (70%) of the cases reviewed, allowing prompt treatment.
Functional assessment in the form of electrophysiology is an important tool in aiding in diagnosis, follow-up and long term management of patients with posterior uveitis.