Baseline OCT biomarkers associated with visual prognosis in cystoid macular edema secondary to noninfectious uveitis

To evaluate the relationship between baseline optical coherence tomography (OCT) biomarkers and both baseline and post-treatment best-corrected visual acuity (BCVA) in eyes with cystoid macular edema (CME) secondary to noninfectious uveitis.

This retrospective study included 84 eyes from 66 patients with uveitic CME showing anatomical resolution after treatment. Baseline OCT parameters, including central foveal thickness (CFT), subretinal fluid (SRF) height, total intraretinal cyst (IRC) volume, hyperreflective foci (HRF) count, and integrity of the ellipsoid zone (EZ), external limiting membrane (ELM), and disorganization of retinal inner layers (DRIL), were analyzed. Univariate and multivariate linear regression analyses were used to identify predictors of baseline and final BCVA.

In univariate analysis, baseline BCVA was significantly associated with CFT (p < 0.001), DRIL presence (p = 0.021), and SRF height (p = 0.002). In multivariate analysis, CFT (p = 0.038) and SRF height (p = 0.049) remained independent predictors. For final BCVA, univariate associations were found with EZ (p = 0.007) and ELM disruption (p = 0.007), total IRC volume (p = 0.010), and baseline CFT (p < 0.001), whereas only baseline CFT (p = 0.006) persisted as an independent predictor.

Increased baseline CFT was significantly associated with poorer visual acuity both at baseline and after treatment, emerging as the strongest independent predictor of visual outcome. In univariate analysis, SRF height, EZ and ELM disruption, DRIL presence, and higher total IRC volume showed associations with BCVA; however, these relationships were not retained in the multivariate model and therefore were not independent predictors after adjusting for covariates.