Different Modality of Treatment in the Neovascularization of Uveitis According to Nonperfusion Area

Shin, Young Joo; Lee, Jun Kyo; Chung, Hum

Abstract

PURPOSE: To help the treatment decision of the intraocular neovascularization(NV) in uveitis patient by analyzing the effect of different treatment modality according to extent of nonperfusion area.
METHODS
The authors reviewed the uveitic patients who occured intraocular NV from Jan. 1991 to Dec. 1999 at Seoul National University Hospital. The authors divided them into two groups in regard of the size of capillary nonperfusion by fluorescein angiography ; the nonischemic group in which the area of capillary nonperfusion is less than 10 disc area, and the ischemic group in which the area is more than 10 disc area. The regression of NV between the two groups was compared according to treatment modality such as medication, laser photocoagulation and vitrectomy.
RESULTS
The NV occured 32 of total 64 eyes ; the nonischemic group included 32 eyes and ischemic group 32 eyes. The medication achieved a significant reduction of NV in nonischemic group(25 of 33 eyes) compared to ischemic group(p=0.01). The laser photocoagulation achieved a significant reduction of NV in ischemic group(16 of 24 eyes) compared to nonischemic group(p=0.064). In 30 eyes with vitrectomy, the NV reduced in 23 eyes and there was no statistical difference between the two groups in reduction of NV(p=0.398).
CONCLUSION
This study suggests that retinal neovascularization can be induced by both retinal ischemia and inflammation, and the inflammation plays an important part in NV in nonischemic group, whereas the retinal ischemia plays a more important part in ischemic group. Therefore, the combined treatment with laser photocoagulation can result in a better outcome in the group with large ischemic area.