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Guenther SR, Schumann RG, Hagenau F, Wolf A, Priglinger SG, Vogt D. Comparison of Surgically Excised Premacular Membranes in Eyes with Macular Pucker and Proliferative Vitreoretinopathy. Curr Eye Res 2019; 44:341-349. [PMID: 30373411 DOI: 10.1080/02713683.2018.1542006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE To describe and compare characteristics of premacular membranes in idiopathic macular pucker (iMP) and proliferative vitreoretinopathy (PVR) using immunofluorescence and transmission electron microscopy. MATERIALS AND METHODS For immunocytochemical and ultrastructural analyses, premacular membranes were harvested during vitrectomy from 16 eyes with iMP and 12 eyes with PVR. All specimens were processed as flat mounts for phase-contrast and fluorescence microscopy. We used 19 different primary antibodies such as anti-α-smooth muscle actin (α-SMA), anti-integrin-αv, anti-galectin, anti-IBA-1, anti-EMMPRIN (CD147), anti-ricinus (RCS) and anti-collagen-type I. Eight of 28 eyes were also prepared for transmission electron microscopy. RESULTS In all eyes with iMP and PVR, positive immunoreactivity of integrins, especially αvβ3 was found. There was also a strong staining of anti-α-SMA, anti-galectin, anti-EMMPRIN, anti-RCS, anti-IBA1 and anti-collagen-type I. Transmission electron microscopy showed that premacular membrane of iMP composed of myofibroblasts, glial cells and fibroblasts. In eyes with PVR, retinal pigment epithelial cells and myofibroblasts were seen as predominant cell types. CONCLUSION Premacular membranes of iMP and PVR presented with similarities in cell distribution and immunoreactivity, but showed differences in cell composition. Herein, we demonstrate immunocytochemical characteristics involved in fibrotic processes. Cell transdifferentiation into myofibroblasts represents an important process in pathogenesis of both entities. In order to address future anti-fibrotic treatment strategies, we emphasize that both fibrotic diseases share distinct immunocytochemical and ultrastructural features.
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Affiliation(s)
- Stefanie R Guenther
- a Department of Ophthalmology , Ludwig-Maximilians-University , Munich , Germany
| | - Ricarda G Schumann
- a Department of Ophthalmology , Ludwig-Maximilians-University , Munich , Germany
| | - Felix Hagenau
- a Department of Ophthalmology , Ludwig-Maximilians-University , Munich , Germany
| | - Armin Wolf
- a Department of Ophthalmology , Ludwig-Maximilians-University , Munich , Germany
| | | | - Denise Vogt
- a Department of Ophthalmology , Ludwig-Maximilians-University , Munich , Germany
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152
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Jang M, Kim JY, Lee SY, Jeong JH, Lee EK. The Effect of Epiretinal Membrane on Dexamethasone Implant for Branch Retinal Vein Occlusion Macular Edema. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.9.843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Mirinae Jang
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
| | - Jin Young Kim
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
| | - Sang-Yoon Lee
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
| | - Jin Ho Jeong
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
| | - Eun Kyoung Lee
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
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153
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Lee MS, Bang CW, Song DY, Bang JW, Jeon HM, Yoon HS. Visual and Structural Differences in Idiopathic Epiretinal Membrane According to the Presence of Retinoschisis. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.11.1080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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154
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Kowallick A, Fischer CV, Hoerauf H. Optical coherence tomography findings in patients prior to cataract surgery regarded as unremarkable with ophthalmoscopy. PLoS One 2018; 13:e0208980. [PMID: 30533037 PMCID: PMC6289407 DOI: 10.1371/journal.pone.0208980] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/28/2018] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To investigate the feasibility and diagnostic benefit of routinely performed preoperative macular spectral-domain (SD-) optical coherence tomography (OCT) for the detection of macular pathology in patients with normal biomicroscopic funduscopy prior to cataract surgery. METHODS Prospective, single center study. A total of 162 eyes of 123 consecutive patients referred for cataract surgery with a visual acuity better than 20/100, absence of macular symptoms such as metamorphopsia, no history of previous intravitreal procedures and a normal funduscopic appearance on biomicroscopy underwent an additional SD-OCT-examination prior to cataract surgery. OCT-scans were classified in three categories: normal, degenerative vitreous changes without impact on visual outcome or pathological with potential impact on visual outcome. RESULTS 80 eyes (49.38%) showed normal OCT-scans. 69 eyes (42.59%) were classified as degenerative vitreous changes without impact on visual outcome and 20 eyes (12.35%) as pathological with potential impact on visual outcome. The indication of cataract surgery or the therapeutic strategy remained unchanged in all patients. In patients with pathological alterations further follow-up examinations were recommended. CONCLUSIONS Routine SD-OCT-imaging of the macular region in patients prior to cataract surgery was feasible to detect macular pathologies in a considerable number of patients, which remained undiagnosed on biomicroscopic funduscopy. Although OCT-findings did not impact therapeutic strategy in this study, preoperative judgement of the expected visual outcome and patient´s informed consent can improve.
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Affiliation(s)
- Antonia Kowallick
- Department of Ophthalmology, University Medical Center Goettingen, Germany
| | | | - Hans Hoerauf
- Department of Ophthalmology, University Medical Center Goettingen, Germany
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155
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Awadalla MS, Fitzgerald J, Andrew NH, Zhou T, Marshall H, Qassim A, Hassall M, Casson RJ, Graham SL, Healey PR, Agar A, Galanopoulos A, Phipps S, Chappell A, Landers J, Craig JE. Prevalence and type of artefact with spectral domain optical coherence tomography macular ganglion cell imaging in glaucoma surveillance. PLoS One 2018; 13:e0206684. [PMID: 30517101 PMCID: PMC6281246 DOI: 10.1371/journal.pone.0206684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 10/17/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose The ganglion cell analysis (GCA) of the CIRRUSTM HD-OCT (Carl Zeiss, Meditec; Dublin, CA) provides measurement of the macular ganglion cell-inner plexiform layer (GCIPL) thickness. This study determined the frequency of scan artefacts and errors in GCIPL imaging in individuals undergoing HD-OCT surveillance for glaucoma. Method A total of 1439 eyes from 721 subjects enrolled in a prospective study assessing predictors of glaucoma progression underwent macular GCIPL imaging with the CIRRUS HD-OCT at recruitment. The prevalence of acquisition errors, segmentation errors, and co-morbid macular pathology was determined. Results A total of 87 (6.0%) of the 1439 scans had either acquisition errors, segmentation artefacts, or other macular pathology. The most common co-morbid macular pathology was epiretinal membrane in 2.2% of eyes. Conclusion The macular GCIPL scan was artefact free in 94% of eyes. However, epiretinal membrane and high myopia can cause scan artefact and should be considered when interpreting the results.
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Affiliation(s)
- Mona S. Awadalla
- Flinders University, Department of Ophthalmology, South Australia, Australia
- * E-mail:
| | - Jude Fitzgerald
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Nicholas H. Andrew
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Tiger Zhou
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Henry Marshall
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Ayub Qassim
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Mark Hassall
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Robert J. Casson
- University of Adelaide, Discipline of Ophthalmology & Visual Sciences, Adelaide, Australia
| | - Stuart L. Graham
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Paul R. Healey
- University of Sydney Discipline of Ophthalmology, Sydney, Australia
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Ashish Agar
- Marsden Eye Specialists, Sydney, Australia
- Department of Ophthalmology, Prince of Wales Hospital, University of New South Wales, Sydney, Australia
| | - Anna Galanopoulos
- University of Adelaide, Discipline of Ophthalmology & Visual Sciences, Adelaide, Australia
| | | | - Angela Chappell
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - John Landers
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Jamie E. Craig
- Flinders University, Department of Ophthalmology, South Australia, Australia
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156
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Zur D, Iglicki M, Feldinger L, Schwartz S, Goldstein M, Loewenstein A, Barak A. Disorganization of Retinal Inner Layers as a Biomarker for Idiopathic Epiretinal Membrane After Macular Surgery-The DREAM Study. Am J Ophthalmol 2018; 196:129-135. [PMID: 30179599 DOI: 10.1016/j.ajo.2018.08.037] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 08/22/2018] [Accepted: 08/24/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Epiretinal membrane (ERM) can cause distortion and disorganization of all inner retinal layers. The purpose of our study was to evaluate the extent of disorganization of the retinal inner layers (DRIL) and to investigate its predictive value for visual outcome in cases of idiopathic ERM that were treated by pars plana vitrectomy (PPV) and ERM peeling. DESIGN Multicenter international retrospective case series. METHODS In 90 eyes from 90 patients with idiopathic ERM treated by PPV and membrane peeling with 12-month follow-up, optical coherence tomography (OCT) scans previous to surgery were evaluated for presence and severity of DRIL, central foveal subfield thickness (CST), maximal retinal thickness (MRT), presence of intraretinal cystoid changes and subretinal fluid, and integrity of the inner/outer segment layer and of the interdigitation zone. Best-corrected visual acuity (BCVA), CST, and MRT were recorded at baseline and at 3, 6, and 12 months after surgery. Correlations between baseline OCT measures (DRIL) and functional and visual outcome were analyzed. Main outcome measures are presence and severity of DRIL at baseline; anatomic and functional outcomes after 3, 6, and 12 months; and the correlation between DRIL and baseline characteristics and outcome measures. RESULTS Patients without and with mild DRIL had a significantly better baseline BCVA compared with patients with severe DRIL (0.61 ± 0.13, 0.56 ± 0.23, 0.73 ± 0.20 [logMAR], respectively). BCVA, CST, and MRT at baseline were statistically significantly correlated with DRIL severity (P = .003, P < .001, and P < .001, respectively). DRIL status before surgery showed a statistically significant interaction with change in BCVA, CST, and MRT over 12 months (P < .001 for all). Patients without and with mild DRIL gained a mean of 3 lines of vision after 12 months, in contrast to 1 line in patients with severe DRIL. CONCLUSIONS DRIL grading correlates with functional and anatomic measures in patients with idiopathic ERM and could serve as a biomarker to predict outcome after surgery. Patients with severe DRIL have limited benefits from surgery. This should be considered in the decision process whether to perform ERM peeling in this patient group.
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CORRELATION BETWEEN INNER-RETINAL CHANGES AND OUTER-RETINAL DAMAGE IN PATIENTS WITH IDIOPATHIC EPIRETINAL MEMBRANE. Retina 2018; 38:2327-2335. [DOI: 10.1097/iae.0000000000001875] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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158
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Huang KH, Weng TH, Chen YJ, Chang YH. Iatrogenic Posterior Lens Capsule Rupture and Subsequent Complications due to Nd:YAG Laser Vitreolysis for Vitreous Floaters: A Case Report. Ophthalmic Surg Lasers Imaging Retina 2018; 49:e214-e217. [DOI: 10.3928/23258160-20181101-21] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 05/09/2018] [Indexed: 11/20/2022]
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159
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Liesenborghs I, De Clerck EE, Berendschot TT, Goezinne F, Schram MT, Henry RM, Stehouwer CD, Webers CA, Schouten JS. Prevalence of optical coherence tomography detected vitreomacular interface disorders: The Maastricht Study. Acta Ophthalmol 2018; 96:729-736. [PMID: 29369516 PMCID: PMC6282828 DOI: 10.1111/aos.13671] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 11/16/2017] [Indexed: 12/22/2022]
Abstract
Purpose To calculate the prevalence of all vitreomacular interface (VMI) disorders and stratify according to age, sex and (pre)diabetes status. Methods The presence of VMI disorders was assessed in 2660 participants aged between 40 and 75 years from The Maastricht Study who had a gradable macular spectral‐domain optical coherence tomography (SD‐OCT) volume scan in at least one eye [mean 59.7 ± 8.2 years, 50.2% men, 1531 normal glucose metabolism (NGM), 401 prediabetes, 728 type 2 diabetes (DM2, oversampled)]. A stratified and multivariable logistic regression analysis was used. Results The prevalence of the different VMI disorders for individuals with NGM, prediabetes and DM2 was, respectively, 5.7%, 6% and 6.7% for epiretinal membranes; 6%, 9.6% and 6.8% for vitreomacular traction; 1.1%, 0.7% and 0.3% for lamellar macular holes; 0.1%, 0% and 0% for pseudoholes; 1.1%, 1.9% and 5.5% for macular cysts. None of the participants was diagnosed with a macular hole. The prevalence of epiretinal membranes, vitreomacular traction and macular cysts was higher with age (p < 0.001). Vitreomacular traction and lamellar macular holes were more frequent in women (p < 0.01). DM2 is positively associated [OR = 3.9 (95% CI 2.11–7.22, p < 0.001)] with macular cysts and negatively associated with lamellar macular holes [OR = 0.2 (95% CI 0.04–0.9, p = 0.036)] after adjustment for age and sex. The calculated prevalence of VMI disorders was 15.9%. Conclusions The calculated prevalence of VMI disorders in individuals aged between 40 and 75 years is 15.9%. The prevalence depends on age, sex and glucose metabolism status for several types of VMI disorders.
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Affiliation(s)
- Ilona Liesenborghs
- Department of Ophthalmology; Maastricht University Medical Center+; Maastricht The Netherlands
| | - Eline E.B. De Clerck
- Department of Ophthalmology; Maastricht University Medical Center+; Maastricht The Netherlands
| | - Tos T.J.M. Berendschot
- Department of Ophthalmology; Maastricht University Medical Center+; Maastricht The Netherlands
| | - Fleur Goezinne
- Department of Ophthalmology; Maastricht University Medical Center+; Maastricht The Netherlands
| | - Miranda T. Schram
- Department of Internal Medicine; Maastricht University Medical Center+; Maastricht The Netherlands
- Carim, Maastricht University Medical Center+; Maastricht The Netherlands
- Heart and Vascular Centre; Maastricht University Medical Center+; Maastricht The Netherlands
| | - Ronald M.A. Henry
- Department of Internal Medicine; Maastricht University Medical Center+; Maastricht The Netherlands
| | - Coen D.A. Stehouwer
- Department of Internal Medicine; Maastricht University Medical Center+; Maastricht The Netherlands
- Carim, Maastricht University Medical Center+; Maastricht The Netherlands
| | - Carroll A.B. Webers
- Department of Ophthalmology; Maastricht University Medical Center+; Maastricht The Netherlands
| | - Jan S.A.G. Schouten
- Department of Ophthalmology; Maastricht University Medical Center+; Maastricht The Netherlands
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160
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Tanaka Y, Toyoda F, Shimmura-Tomita M, Kinoshita N, Takano H, Dobashi Y, Yamada S, Obata H, Kakehashi A. Clinicopathological features of epiretinal membranes in eyes filled with silicone oil. Clin Ophthalmol 2018; 12:1949-1957. [PMID: 30323552 PMCID: PMC6177381 DOI: 10.2147/opth.s180381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this case series was to clarify the clinicopathological features of epiretinal membranes (ERMs) that developed in eyes after silicone oil (SO) tamponade to treat rhegmatog-enous retinal detachments (RRDs). Patients and methods In the Department of Ophthalmology, Saitama Medical Center, Jichi Medical University, patients with idiopathic ERMs (23 eyes) and ERMs in eyes filled with SO (SO ERMs) after vitreous surgery to treat RRDs (nine eyes) were enrolled from July 2012 to March 2014. ERM tissues obtained intraoperatively were examined histopathologically. Besides the main outcome measure of the pathological findings of the ERM tissues, other outcome measures included the preoperative findings on optical coherence tomography (OCT) images and the surgical findings. Results Eight (89%) of nine eyes with SO ERMs had bilayered membranes composed of a firm layer on the retinal side with glial cells and extracellular matrix and a fragile sponge-like layer on the vitreous side. The sponge-like layer was composed of emulsified SO surrounded by macrophages. Quantitative analysis showed that the areas with cluster of differentiation 68 (CD68)-positive macrophages identified by immunohistochemistry in eyes with SO ERMs were significantly (P<0.001) larger than those in eyes with idiopathic ERMs. The findings on OCT images were consistent with the pathological features of the SO ERMs. Surgical removal of the SO ERMs was difficult because the sponge-like layer was fragile, and the underlying retina was also fragile due to inflammation. Conclusion SO ERMs are bilayered membranes. Long-standing emulsified SO formed a sponge-like layer and SO (foreign body)-induced granulation and caused retinal inflammation in these eyes, making surgical removal difficult. A preoperative OCT examination is necessary to identify SO ERMs.
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Affiliation(s)
- Yoshiaki Tanaka
- Department of Ophthalmology, Saitama Medical Center, Jichi Medical University, Saitama, Japan,
| | - Fumihiko Toyoda
- Department of Ophthalmology, Saitama Medical Center, Jichi Medical University, Saitama, Japan,
| | - Machiko Shimmura-Tomita
- Department of Ophthalmology, Saitama Medical Center, Jichi Medical University, Saitama, Japan,
| | - Nozomi Kinoshita
- Department of Ophthalmology, Saitama Medical Center, Jichi Medical University, Saitama, Japan,
| | - Hiroko Takano
- Department of Ophthalmology, Saitama Medical Center, Jichi Medical University, Saitama, Japan,
| | - Yoh Dobashi
- Department of Pathology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Shigeki Yamada
- Department of Pathology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hiroto Obata
- Department of Ophthalmology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Akihiro Kakehashi
- Department of Ophthalmology, Saitama Medical Center, Jichi Medical University, Saitama, Japan,
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161
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Chen X, Klein KA, Shah CP, Heier JS. Progression to Surgery for Patients With Idiopathic Epiretinal Membranes and Good Vision. Ophthalmic Surg Lasers Imaging Retina 2018; 49:S18-S22. [PMID: 30339263 DOI: 10.3928/23258160-20180814-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 08/08/2018] [Indexed: 11/20/2022]
Abstract
BACKROUND AND OBJECTIVE Patients with idiopathic epiretinal membranes (ERMs) and visual acuity of 20/40 or better are often monitored until vision or associated symptoms worsen to affect everyday living. This study looks at the rate of progression to surgery and the characteristics associated with progression. PATIENTS AND METHODS This study was a retrospective, consecutive case series of patients with newly diagnosed idiopathic ERMs who were referred to the Retina Service at the Ophthalmic Consultants of Boston between January 2009 and May 2015 with 20/40 or better visual acuity. Surgical membrane peel was typically offered when vision worsened to 20/50 or beyond and/or when patients could not tolerate symptoms attributable to the ERM. All eligible eyes were categorized by baseline optical coherence tomography (OCT) morphology into normal, mild or incomplete, or complete loss of foveal contour. Visual acuities were averaged through conversion to logMAR. Kaplan-Meier survival curves for progression to surgical membrane peel were calculated. The main outcome measure was progression to surgical intervention. RESULTS The study included 201 eyes from 170 patients; 29.8% had normal, 18.9% had mild loss, and 51.2% had complete loss of foveal contour on baseline OCT. Overall, 13% of eyes progressed to surgery at 7 years. However, only 5% of eyes with normal foveal contour progressed to surgery by 5.5 years, whereas 17% with incomplete and 16% with complete loss of foveal contour progressed to surgery at 6 and 7 years, respectively. Eyes with worse foveal contours progressed to surgery more rapidly. CONCLUSION A minority of patients with newly diagnosed ERMs who did not need surgical intervention progressed to needing surgery at 7 years with the rate and speed of progression dependent on baseline OCT morphology. These statistics can be useful in counseling patients who are deciding between watchful waiting and surgical intervention. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:S18-S22.].
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162
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Sonobe T, Tabuchi H, Ohsugi H, Masumoto H, Ishitobi N, Morita S, Enno H, Nagasato D. Comparison between support vector machine and deep learning, machine-learning technologies for detecting epiretinal membrane using 3D-OCT. Int Ophthalmol 2018; 39:1871-1877. [PMID: 30218173 DOI: 10.1007/s10792-018-1016-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 09/01/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE In this study, we compared deep learning (DL) with support vector machine (SVM), both of which use three-dimensional optical coherence tomography (3D-OCT) images for detecting epiretinal membrane (ERM). METHODS In total, 529 3D-OCT images from the Tsukazaki hospital ophthalmology database (184 non-ERM subjects and 205 ERM patients) were assessed; 80% of the images were divided for training, and 20% for test as follows: 423 training (non-ERM 245, ERM 178) and 106 test (non-ERM 59, ERM 47) images. Using the 423 training images, a model was created with deep convolutional neural network and SVM, and the test data were evaluated. RESULTS The DL model's sensitivity was 97.6% [95% confidence interval (CI), 87.7-99.9%] and specificity was 98.0% (95% CI, 89.7-99.9%), and the area under the curve (AUC) was 0.993 (95% CI, 0.993-0.994). In contrast, the SVM model's sensitivity was 97.6% (95% CI, 87.7-99.9%), specificity was 94.2% (95% CI, 84.0-98.7%), and AUC was 0.988 (95% CI, 0.987-0.988). CONCLUSION DL model is better than SVM model in detecting ERM by using 3D-OCT images.
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Affiliation(s)
- Tomoaki Sonobe
- Department of Ophthalmology, Tsukazaki Hospital, 68-1 Waku, Aboshi-ku, Himeji, 671-1227, Japan.
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Tsukazaki Hospital, 68-1 Waku, Aboshi-ku, Himeji, 671-1227, Japan
| | - Hideharu Ohsugi
- Department of Ophthalmology, Tsukazaki Hospital, 68-1 Waku, Aboshi-ku, Himeji, 671-1227, Japan
| | - Hiroki Masumoto
- Department of Ophthalmology, Tsukazaki Hospital, 68-1 Waku, Aboshi-ku, Himeji, 671-1227, Japan
| | - Naohumi Ishitobi
- Department of Ophthalmology, Tsukazaki Hospital, 68-1 Waku, Aboshi-ku, Himeji, 671-1227, Japan
| | - Shoji Morita
- Research Group of Intelligent Cybernetics and Computer Science Graduate School of Engineering, University of Hyogo, Himeji, Japan
| | | | - Daisuke Nagasato
- Department of Ophthalmology, Tsukazaki Hospital, 68-1 Waku, Aboshi-ku, Himeji, 671-1227, Japan
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163
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Epiretinal Membrane Surgery Outcomes in Eyes with Subretinal Drusenoid Deposits: A Case Control Study. Ophthalmol Retina 2018; 2:1218-1226. [PMID: 31047194 DOI: 10.1016/j.oret.2018.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 06/09/2018] [Accepted: 06/19/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate outcomes of epiretinal membrane (ERM) surgery in eyes with subretinal drusenoid deposits (SRDDs) and to compare them with those with isolated ERM. DESIGN Retrospective case-control study of consecutive patients who underwent pars plana vitrectomy (PPV) with ERM peeling. PARTICIPANTS Twenty-five patients with SRDDs on spectral-domain (SD)-OCT who underwent surgery for ERM were included in the study. From the same cohort, for each case, we selected 2 age-matched control participants (50 eyes with isolated ERM). Preoperative best-corrected visual acuity (BCVA) also was matched as closely as possible. METHODS All participants underwent PPV and ERM peel for primary ERM. MAIN OUTCOME MEASURES Postoperative BCVA, improvement in BCVA, preoperative and postoperative central macular thickness, surgical complications, and development of age-related macular degeneration (AMD) were recorded. RESULTS At final examination, mean postoperative BCVA was significantly less for eyes with SRDDs (0.51 logarithm of the minimal angle of resolution [logMAR] vs. 0.21 logMAR; P = 0.0001). Eyes with SRDDs demonstrated less improvement in BCVA after ERM surgery (0.13 logMAR vs. 0.30 logMAR; P = 0.0032). Eyes with SRDDs were significantly less likely to gain 2 or more Snellen lines of BCVA after ERM surgery (28% vs. 56%; P = 0.028). Three of 25 patients (12%) undergoing ERM surgery showed worsening of Snellen BCVA by 2 lines or more. Three of 25 eyes (12%) with SRDDs demonstrated advanced AMD after surgery, compared with 0 participants in the control group (P = 0.034). CONCLUSIONS Epiretinal membrane surgery in eyes with SRDDs is associated with less favorable visual outcomes. Fewer patients demonstrate gain in BCVA, whereas a significant number show a deleterious decline. After surgery, AMD incidence seems high and patients may have an increased risk of raised intraocular pressure. These findings require further study to establish whether this represents a causal relationship. Surgeons should be vigilant for these complications. Appropriate patient counseling during the consenting process must be made.
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164
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Fajgenbaum MAP, Wong RS, Laidlaw DAH, Williamson TH. Vitreoretinal surgery on the fellow eye: A retrospective analysis of 18 years of surgical data from a tertiary center in England. Indian J Ophthalmol 2018; 66:681-686. [PMID: 29676315 PMCID: PMC5939163 DOI: 10.4103/ijo.ijo_1176_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose: To determine the long-term incidence of fellow-eye surgical involvement in patients who have undergone first-eye vitreoretinal (VR) surgery for a variety of indications. This was a single-institution retrospective, consecutive series. Methods: Eighteen years of electronic surgical data were reviewed at our institution. All patients having surgery for the following indications were included: rhegmatogenous retinal detachment (RRD), macular hole (MH), epiretinal membrane (ERM), proliferative diabetic retinopathy (PDR), vitritis, and dropped nucleus. Primary outcome was the cumulative incidence of fellow-eye surgery at 10 years by Kaplan–Meier analysis. Results: Total follow-up was 29,629 patient-years. Cumulative incidence (± standard error) of fellow-eye surgery at 10 years was 7.2% ± 0.6% for RRD, 9.1% ± 1.3% for ERM, 7.5% ± 1.8% for MH, 30.6% ± 1.9% for PDR, 13.7% ± 2.9% for vitritis, and 2.8% ± 1.6% for dropped nuclei. The hazard for second-eye surgery was greatest in the early postoperative period after first-eye surgery for all indications. For RRD, the hazard was 2.7% ± 0.3% at year 1, 1.1% ± 0.2% at year 2, and 0.5% ± 0.2% at year 5. Risk factors for fellow-eye involvement for RRD were younger age (P < 0.001) and male gender (P < 0.01). Conclusion: We report the long-term risk of fellow-eye involvement in various VR pathologies, which is important in counseling patients regarding their risks as well as planning service provision.
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Affiliation(s)
| | - Roger S Wong
- Department of Ophthalmology, St. Thomas' Hospital, London SE1 7EH, UK
| | - David A H Laidlaw
- Department of Ophthalmology, St. Thomas' Hospital, London SE1 7EH, UK
| | - Tom H Williamson
- Department of Ophthalmology, St. Thomas' Hospital, London SE1 7EH, UK
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Vogt D, Vielmuth F, Wertheimer C, Hagenau F, Guenther SR, Wolf A, Spindler V, Priglinger SG, Schumann RG. Premacular membranes in tissue culture. Graefes Arch Clin Exp Ophthalmol 2018; 256:1589-1597. [PMID: 29931427 DOI: 10.1007/s00417-018-4033-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/04/2018] [Accepted: 05/31/2018] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To investigate integrity and characteristics of human premacular membranes (PMM) with and without standard tissue culturing using mechanical traction. METHODS Premacular membranes were harvested from 32 eyes of 32 patients with idiopathic macular pucker during standard vitrectomy. By flat-mount preparation with phase contrast and interference microscopy, specimens were prepared for time-lapse microscopy, immunocytochemistry, and transmission electron microscopy. Sixteen of 32 specimens were held in tissue culture with tangential traction by using entomological pins. Of these, specimens of 7 eyes were analyzed with and without tissue culturing for comparison. Primary antibodies were used for myofibroblasts, hyalocytes, macro-/microglial cells, and retinal pigment epithelial and immune cells. RESULTS Hyalocytes, macroglia, and microglia composed the main cell composition of surgically removed PMM. Correlation of time-lapse microscopy with immunofluorescence microscopy identified fast and unidirectional moving small round cells as microglia. Slowly moving elongated large cells were characterized as alpha-smooth muscle actin (α-SMA)-positive myofibroblasts. Following tissue culturing with tangential stretch, enhanced positive immunolabelling for α-SMA and integrins-αv was seen. All other labelling results were demonstrated to be similar with pre-culture conditions. Ultrastructural analysis revealed fibroblasts, myofibroblasts, and proliferation of glial cells following tissue culture. CONCLUSION This study demonstrates abundance of fibroblasts, myofibroblasts, and glial cells in PMM from idiopathic macular pucker following tissue culture with tangential stretch application. We found enhanced contractive properties of the cultured PPM that appear to indicate transdifferentiation of the cell composition. This in vitro model may improve understanding of pathogenesis in traction maculopathies and help to establish further anti-fibrosis treatment strategies.
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Affiliation(s)
- Denise Vogt
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany.
| | - Franziska Vielmuth
- Institute of Anatomy and Cell Biology, Department I, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Christian Wertheimer
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Felix Hagenau
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Stefanie R Guenther
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Armin Wolf
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Volker Spindler
- Institute of Anatomy and Cell Biology, Department I, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Siegfried G Priglinger
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Ricarda G Schumann
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
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Chen T, Su B, Chen Z, Tong J, Bedell H, Song Z, Zhang B. The Associations among Metamorphopsia, Orientation Discrimination Threshold, and Retinal Layer Thickness in Patients with Idiopathic Epiretinal Membrane. Curr Eye Res 2018; 43:1151-1159. [PMID: 29804466 DOI: 10.1080/02713683.2018.1481515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Tianyu Chen
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Binbin Su
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zheyi Chen
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | | | - Harold Bedell
- College of optometry, University of Houston, Houston, TX, USA
| | - Zongming Song
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bin Zhang
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- College of Optometry, Nova Southeastern University, Davie, FL, USA
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Forsaa VA, Lindtjørn B, Kvaløy JT, Frøystein T, Krohn J. Epidemiology and morphology of full-thickness macular holes. Acta Ophthalmol 2018; 96:397-404. [PMID: 29197164 DOI: 10.1111/aos.13618] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 09/02/2017] [Indexed: 12/01/2022]
Abstract
PURPOSE To investigate the incidence of full-thickness macular holes (FTMHs) and their morphological features according to the International Vitreomacular Traction Study (IVTS) classification. METHODS The clinical records of all new patients with FTMH, referred between 2008 and 2014, were reviewed for demographics, cause of the FTMH, age at diagnosis, symptom duration, laterality, visual acuity (VA), axial length and lens status. A detailed analysis of the patients' spectral domain optical coherence tomography (SD-OCT) images was performed, and the primary FTMHs were classified in clinical stages according to the IVTS classification. From the SD-OCT, accurate macula drawings were made by means of a computer-drawing software. By merging these drawings and displaying them as colour-coded maps, the morphology and shape of the FTMH were visualized. RESULTS The study included 177 eyes (152 primary and 25 secondary FTMH) in 166 patients. In primary FTMH, the male-to-female ratio was 1:2.2. The age- and gender-adjusted annual incidences of primary FTMH were 7.9 eyes and 7.4 individuals per 100 000 inhabitants. Mean primary FTMH minimum linear diameter (MLD) and basal diameter (BD) were 435 μm and 872 μm, respectively, and 13% were classified as small, 31% as medium and 55% as large. Vitreomacular traction (VMT) and epiretinal membrane (ERM) were present in 34% and 36% of the eyes, respectively. CONCLUSION This study provides data on the incidence rates of FTMH adjusted to different standard populations. The morphological analysis and novel computational visualization technique offer new insight into the structural complexity of FTMH and how VMT and ERM significantly influence FTMH configuration.
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Affiliation(s)
- Vegard Asgeir Forsaa
- Department of Ophthalmology; Stavanger University Hospital; Stavanger Norway
- Department of Clinical Medicine; Section of Ophthalmology; University of Bergen; Bergen Norway
| | - Birger Lindtjørn
- Department of Ophthalmology; Stavanger University Hospital; Stavanger Norway
| | - Jan Terje Kvaløy
- Department of Research; Stavanger University Hospital; Stavanger Norway
- Department of Mathematics and Natural Sciences; University of Stavanger; Stavanger Norway
| | - Torbjørn Frøystein
- Department of Oncology and Medical Physics; Haukeland University Hospital; Bergen Norway
| | - Jørgen Krohn
- Department of Clinical Medicine; Section of Ophthalmology; University of Bergen; Bergen Norway
- Department of Ophthalmology; Haukeland University Hospital; Bergen Norway
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Mikhail M, Stewart S, Seow F, Hogg R, Lois N. Vitreomacular interface abnormalities in patients with diabetic macular oedema and their implications on the response to anti-VEGF therapy. Graefes Arch Clin Exp Ophthalmol 2018; 256:1411-1418. [PMID: 29779188 PMCID: PMC6060772 DOI: 10.1007/s00417-018-4009-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/30/2018] [Accepted: 05/03/2018] [Indexed: 11/30/2022] Open
Abstract
Purpose To determine whether the presence of vitreomacular interface abnormalities (VMIA) in patients with diabetic macular oedema (DMO) modifies the response to ranibizumab. Methods Medical records and spectral-domain optical coherence tomography (SD-OCT) scans of consecutive patients with centre-involving DMO initiating therapy with ranibizumab between December 2013 and March 2014 at the Belfast Health and Social Care Trust were reviewed. Patients were identified through an electronic database. Demographics; systemic baseline characteristics; history of previous ocular surgery/laser; best-corrected visual acuity (BCVA), central retinal thickness (CRT) and stage of retinopathy at presentation; and BCVA, CRT and presence/absence of fluid at the last follow-up were recorded. OCT scans were reviewed by a masked investigator who graded them for the presence/absence of VMIA at baseline and during follow-up and for the change in the posterior hyaloid face during follow-up. The association between (1) VMIA at baseline and (2) the change in the posterior hyaloid face during the follow-up and functional/anatomical outcomes was evaluated. Results One hundred forty-six eyes of 100 patients (mean age 63.5 years) followed for a mean of 9 months (range 2–14 months; only 9/146 dropped to follow-up before month 6) were included. Statistically significant differences were observed at baseline in BCVA (p = 0.007), previous macular laser and panretinal photocoagulation (PRP) (p = 0.006) and previous cataract surgery (p = 0.01) between eyes with and without VMIA, with better levels of vision, higher frequency of macular laser and lower frequency of PRP in eyes where no VMIA was present. Multivariable regression analysis did not disclose any statistically significant associations between VMIA at baseline or change in the posterior hyaloid face during the follow-up and functional and anatomical outcomes following treatment. Conclusion VMIA are associated with worse presenting vision in patients with DMO; VMIA or change in the posterior hyaloid face during the follow-up did not modify the response to ranibizumab in this study.
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Affiliation(s)
- Michael Mikhail
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast, UK
| | - Stephen Stewart
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast, UK
| | - Felicia Seow
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, UK
| | - Ruth Hogg
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, UK
| | - Noemi Lois
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast, UK. .,Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, UK.
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Kromer R, Vogt C, Wagenfeld L, Spitzer MS, Stemplewitz B. Predicting Surgical Success in Patients with Idiopathic Epiretinal Membrane Using the Spectral-Domain Optical Coherence Tomography Segmentation Module for Single Retinal Layer Analysis. Curr Eye Res 2018; 43:1024-1031. [PMID: 29673275 DOI: 10.1080/02713683.2018.1467931] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Idiopathic epiretinal membrane (ERM) is a proliferation of cells formed on the internal surface of the retina and may cause a slow decrease in visual acuity (VA). The aim of this study was to evaluate the individual layers of the retina by optical coherence tomography (OCT) before and after vitrectomy with ERM peeling in order to refine surgical decision-making. METHODS Forty-seven eyes of 45 patients (aged 55-87 years) with ERM were enrolled retrospectively from a tertiary referral center. OCT examination was performed preoperatively and at a mean of 3.2 months postoperatively in all cases. Nine retinal surfaces were subjected to automated all-layer segmentation using the manufacturer's software and assessed for their correlation with VA. RESULTS There was a significant correlation between the initial retinal morphology and change in VA postoperatively. Patients who gained at least two lines of VA had a significantly higher total retinal perimacular volume and retinal nerve fiber layer (each p < 0.0001) preoperatively. CONCLUSION Patients with high preoperative retinal volumes and therefore increased tractive components seemed to benefit more from surgery than those with low tractive components.
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Affiliation(s)
- Robert Kromer
- a Department of Ophthalmology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Clara Vogt
- a Department of Ophthalmology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Lars Wagenfeld
- a Department of Ophthalmology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.,b Eye Clinic Rotherbaum , Hamburg , Germany
| | - Martin Stephan Spitzer
- a Department of Ophthalmology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Birthe Stemplewitz
- a Department of Ophthalmology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.,c Department of Ophthalmology , Asklepios Klinik Barmbek , Hamburg , Germany
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Yang Y, Yan YN, Wang YX, Xu J, Ren J, Xu L, Jonas JB, Wei WB. Ten-year cumulative incidence of epiretinal membranes assessed on fundus photographs. The Beijing Eye Study 2001/2011. PLoS One 2018; 13:e0195768. [PMID: 29698410 PMCID: PMC5919611 DOI: 10.1371/journal.pone.0195768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 03/21/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose To assess the 10-year incidence and progression of epiretinal membranes (ERMs). Methods The population-based longitudinal Beijing Eye Study, which included 4439 subjects (age:40+years) in 2001, was repeated in 2011 with 2695 subjects participating (66.4% of the survivors). The study participants underwent a detailed ophthalmic examination, including retinal photography. Assessing fundus photograohs, ERMs were classified as cellophane macular reflex (CMR) without retinal folds, or as preretinal macular fibrosis (PMF) without or with retinal folds. Results Fundus photographs were available for 2476 subjects with a mean age of 69.0±7.8 years (range:51–93 years) and mean axial length of 23.3±0.9 mm (range:19.92–26.33mm). The 10-year incidence of ERMs was 8.4% (208/2476 participants; 95% confidence interval (CI):7.4,9.5). ERMs developed bilaterally in 50 (24%) individuals and unilaterally in 158 (76%) persons. The incidence of PMFs with 2.5% (95% CI: 1.9, 3.1) was lower than the incidence of CMRs with 5.9% (95% CI: 5.0, 6.9). Higher 10-year incidence of ERMs was associated with older age (P<0.001; odds ratio (OR): 1.06; 95%CI:1.04,1.09), previous cataract surgery (P = 0.003;OR:3.32;95%CI:1.51,7.29) and presence of a complete posterior vitreous detachment (P = 0.02;OR:1.84;95%CI:1.12,3.02). In the age groups of <60 years, 60–69 years, 70–79 years and 80+years, incidence of ERMs was 3.1%, 10.0%, 14.4% and 10.9%, respectively, with no significant gender difference. Conclusions In Chinese aged 40+ years, the 10-year incidence of ERMs (8.4%) increased with older age, previous cataract surgery and complete posterior vitreous detachment. The ten-year incidence was lower for PMFs (2.5%) than for CMRs (5.9%).
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Affiliation(s)
- Yan Yang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Aier-Intech Eye Hospital, Beijing, China
| | - Yan Ni Yan
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jie Xu
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jie Ren
- Beijing Aier-Intech Eye Hospital, Beijing, China
| | - Liang Xu
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jost B. Jonas
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Wen Bin Wei
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- * E-mail:
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EFFECTS OF INTERNAL LIMITING MEMBRANE PEELING COMBINED WITH REMOVAL OF IDIOPATHIC EPIRETINAL MEMBRANE: A Systematic Review of Literature and Meta-Analysis. Retina 2018; 37:1813-1819. [PMID: 28207608 DOI: 10.1097/iae.0000000000001537] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the effects on postoperative prognosis of internal limiting membrane (ILM) peeling in conjunction with removal of idiopathic epiretinal membranes (ERMs). METHODS MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE were systematically searched for studies that compared ILM peeling with no ILM peeling in surgery to remove idiopathic ERM. Outcome measures were best-corrected visual acuity, central macular thickness, and ERM recurrence. Studies that compared ILM peeling with no ILM peeling for the treatment of idiopathic ERM were selected. RESULTS Sixteen studies that included 1,286 eyes were selected. All the included studies were retrospective or prospective comparative studies; no randomized controlled study was identified. Baseline preoperative best-corrected visual acuity and central macular thickness were equal between ILM peeling and no ILM peeling groups. Postoperatively, there was no statistically significant difference in best-corrected visual acuity (mean difference 0.01 logarithm of the minimum angle of resolution [equivalent to 0.5 Early Treatment Diabetic Retinopathy Study letter]; 95% CI -0.05 to 0.07 [-3.5 to 2.5 Early Treatment Diabetic Retinopathy Study letters]; P = 0.83) or central macular thickness (mean difference 13.13 μm; 95% CI -10.66 to 36.93; P = 0.28). However, the recurrence rate of ERM was significantly lower with ILM peeling than with no ILM peeling (odds ratio 0.25; 95% CI 0.12-0.49; P < 0.0001). CONCLUSION Currently available evidence in the literature indicates that additional ILM peeling in vitrectomy for idiopathic ERM could result in a significantly lower ERM recurrence rate, but it does not significantly influence postoperative best-corrected visual acuity and central macular thickness.
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Giambruni JM, Pagano C, Ortiz Basso T, Burchakchi AI, Pozzoni MC, Diamint DV, Challiol CF, Gossn G, Boietti B. Topical prostaglandin analogues and development of epiretinal membrane. ACTA ACUST UNITED AC 2018; 93:169-173. [PMID: 29398231 DOI: 10.1016/j.oftal.2017.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 10/09/2017] [Accepted: 12/11/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To determine whether patients with glaucoma and epiretinal membrane (ERM) use a greater proportion of prostaglandin analogues (PA) than a control group of patients with glaucoma without ERM. METHOD A retrospective study of cases and controls was conducted in order to determine whether patients with glaucoma and ERM used a greater proportion of PA than a control group of patients with glaucoma without ERM. The diagnosis of de ERM was made by clinical examination and optical coherence tomography. RESULTS The mean age of the cases was 77 years (SD: 8.68; 95% CI: 74.3-79.4), compared to the controls with 63 years (SD: 16.6; 95% CI: 70.1-78.5). The cases included 50% (n=26) men and 50% women (n=26), whereas in the controls 25.4% (n=16) of the cases were men and 74.6% (n=47) women. PA treatment was used in 59.6% (n=31) and 60.3% (n=38) of the cases and controls, respectively. There was no statistically significant difference in PA use between the 2groups (P=.939). CONCLUSIONS In this study, an association between the use of AP and the development of ERM could not be demonstrated.
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Affiliation(s)
- J M Giambruni
- Departamento de Oftalmología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - C Pagano
- Departamento de Oftalmología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - T Ortiz Basso
- Departamento de Oftalmología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - A I Burchakchi
- Departamento de Oftalmología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - M C Pozzoni
- Departamento de Oftalmología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - D V Diamint
- Departamento de Oftalmología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - C F Challiol
- Departamento de Oftalmología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - G Gossn
- Departamento de Oftalmología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - B Boietti
- Departamento de Oftalmología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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CHARACTERISTICS OF EPIRETINAL MEMBRANE REMNANT EDGE BY OPTICAL COHERENCE TOMOGRAPHY AFTER PARS PLANA VITRECTOMY. Retina 2018; 37:2078-2083. [PMID: 28590966 DOI: 10.1097/iae.0000000000001466] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the incidence, characteristics, and the progression of epiretinal membrane (ERM) remnant edge seen by optical coherence tomography after ERM peeling. METHODS A retrospective chart review was conducted for 86 eyes of 85 consecutive patients who were diagnosed with ERM and underwent pars plana vitrectomy for epiretinal membrane peeling between 2013 and 2014. Data collected and analyzed included age, gender, preoperative and postoperative visual acuity, use of indocyanine green dye to stain internal limiting membrane, tamponade used after vitrectomy, ERM edge boundaries, presence of cystoid macular edema, and central foveal thickness. RESULTS An ERM remnant edge was detected in 33/86 study eyes (38.4%) at the first postoperative optical coherence tomography scan. Compared with those without an ERM remnant, patients with an ERM remnant after surgery were significantly older at baseline and had a higher incidence of ERM recurrence at their last visit. They were not significantly different in terms of gender, preoperative and postoperative visual acuity, reduction of central foveal thickness from baseline, proportion of eyes with preoperative ERM elevation on optical coherence tomography, presence of macular edema before surgery, intraoperative use of indocyanine green staining for ILM peeling, or tamponade used. Based on the edge morphology, we classified the ERM remnant into three types: Type 1 was flat and blended with the retina (14/33 eyes, 42.4%), Type 2 was flat but stepped (17/33 eyes, 51.5%), and Type 3 was elevated (2/33 eyes, 6.0%). A significantly higher risk of ERM recurrence was seen in Type 2 and Type 3 ERM remnants (75% and 100%, respectively) than Type 1 ERM remnants (10%). CONCLUSION An ERM remnant edge was detected by optical coherence tomography after ERM peeling in 38.4% of eyes. The presence of a postoperative ERM edge was associated with a higher risk of ERM recurrence, particularly in Type 2 and Type 3 ERM remnants.
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Feldman A, Zerbib J, Glacet-Bernard A, Haymann P, Soubrane G. Clinical Evaluation of the Use of Infracyanine Green Staining for Internal Limiting Membrane Peeling in Epimacular Membrane Surgery. Eur J Ophthalmol 2018; 18:972-9. [DOI: 10.1177/112067210801800619] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- A. Feldman
- Service Universitaire d'Ophtalmologie, Centre Hospitalier Intercommunal et Hôpital Henri Mondor (Assistance publique des hôpitaux de Paris), Creteil - France
| | - J. Zerbib
- Service Universitaire d'Ophtalmologie, Centre Hospitalier Intercommunal et Hôpital Henri Mondor (Assistance publique des hôpitaux de Paris), Creteil - France
| | - A. Glacet-Bernard
- Service Universitaire d'Ophtalmologie, Centre Hospitalier Intercommunal et Hôpital Henri Mondor (Assistance publique des hôpitaux de Paris), Creteil - France
| | - P. Haymann
- Service Universitaire d'Ophtalmologie, Centre Hospitalier Intercommunal et Hôpital Henri Mondor (Assistance publique des hôpitaux de Paris), Creteil - France
| | - G. Soubrane
- Service Universitaire d'Ophtalmologie, Centre Hospitalier Intercommunal et Hôpital Henri Mondor (Assistance publique des hôpitaux de Paris), Creteil - France
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Theodossiadis P, Grigoropoulos V, Kyriaki T, Emfietzoglou J, Vergados J, Nikolaidis P, Theodossiadis G. Evolution of Idiopathic Epiretinal Membrane Studied by Optical Coherence Tomography. Eur J Ophthalmol 2018; 18:980-8. [DOI: 10.1177/112067210801800620] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - T. Kyriaki
- 2nd Department of Ophthalmology, Henry Dunant Hospital, Athens - Greece
| | - J. Emfietzoglou
- 2nd Department of Ophthalmology, Henry Dunant Hospital, Athens - Greece
| | - J. Vergados
- 2nd Department of Ophthalmology, University of Athens, Athens - Greece
| | - P. Nikolaidis
- 2nd Department of Ophthalmology, Henry Dunant Hospital, Athens - Greece
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Kim SH, Song SJ, Bae JH. The Incidence and Risk Factors of Epiretinal Membrane in a Screened Korean Population. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.10.922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Seong Ho Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Su Jeong Song
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Hun Bae
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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De Novelli FJ, Goldbaum M, Monteiro MLR, Aggio FB, Nóbrega MJ, Takahashi WY. Recurrence rate and need for reoperation after surgery with or without internal limiting membrane removal for the treatment of the epiretinal membrane. Int J Retina Vitreous 2017; 3:48. [PMID: 29238614 PMCID: PMC5724346 DOI: 10.1186/s40942-017-0101-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 10/28/2017] [Indexed: 11/21/2022] Open
Abstract
Purpose To compare the recurrence rate and need for reoperation after epiretinal membrane surgery with and without removal of the internal limiting membrane. Methods In this retrospective study, 125 patients operated for epiretinal membrane removal were evaluated, with a minimum 6-month follow-up. Removal of the epiretinal membrane (ERM) was performed in 78 patients, while 47 had removal of the epiretinal membrane associated with internal limiting membrane peeling (ERM + ILM). Results The mean age in the ERM group was 65.8 years old, ranging from 41 to 80 years old. In the ERM + ILM group, the mean age was 67.2 years old, ranging from 52 to 82 years old. The mean preoperative visual acuity in the ERM group was 20/80p, and in the ERM + ILM group, it was 20/80. The mean postoperative visual acuity in both groups was 20/30. The mean preoperative macular thickness in the ERM group was 467 µm ranging from 281 to 663 µm; in the ERM + ILM group, the preoperative macular thickness was 497 µm, ranging from 172 to 798 µm. After surgery, a reduction in macular thickness was observed in both groups. In the ERM group, the mean macular thickness reduction was 361 ± 101. µm, whereas in the ERM + ILM group, it was 367 ± 75.2 µm. Twenty-two patients presented with a recurrence of epiretinal membrane, of which 16 (20.5%) were from the ERM group and 6 (12.8%) were from the ERM + ILM group (p = 0.39); one patient (2%) was retreated in the ERM + ILM group, whereas 5 patients (6%) where retreated in the ERM group. Conclusion We postulate that ILM peeling for the treatment of epiretinal membrane is not a relevant factor either for visual recovery or macular thickness reduction, but it may reduce the recurrence and reoperation rate.
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Affiliation(s)
- Fernando José De Novelli
- Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil.,Rua Camboriu 35, Joinville, SC CEP 89216222 Brazil
| | - Mauro Goldbaum
- Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Fabio Bom Aggio
- Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
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Keel S, Xie J, Foreman J, van Wijngaarden P, Taylor HR, Dirani M. Prevalence and associations of epiretinal membranes in the Australian National Eye Health Survey. Acta Ophthalmol 2017; 95:e796-e798. [PMID: 28661065 DOI: 10.1111/aos.13386] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Stuart Keel
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; Melbourne Vic. Australia
| | - Jing Xie
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; Melbourne Vic. Australia
| | - Joshua Foreman
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; Melbourne Vic. Australia
- Department of Surgery; Ophthalmology; University of Melbourne; Melbourne Vic. Australia
| | - Peter van Wijngaarden
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; Melbourne Vic. Australia
- Department of Surgery; Ophthalmology; University of Melbourne; Melbourne Vic. Australia
| | - Hugh R. Taylor
- Indigenous Eye Health Unit; Melbourne School of Population and Global Health; The University of Melbourne; Melbourne Vic. Australia
| | - Mohamed Dirani
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; Melbourne Vic. Australia
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181
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Vieira L, Cabugueira A, Borges B, Carvalho V, Noronha M, Abegão Pinto L, Reina M, Dutra Medeiros M. Secondary Epiretinal Membrane After Trabeculectomy. J Glaucoma 2017; 25:e576-80. [PMID: 26398580 DOI: 10.1097/ijg.0000000000000326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the frequency of epiretinal membranes (ERM) in eyes with primary open-angle glaucoma subjected to trabeculectomy. METHODS We conducted a retrospective study on patients subjected to trabeculectomy with at least a 6-month follow-up. Ophthalmologic examination and spectral-domain optical coherence tomography (SD-OCT) were analyzed. Eyes with previous surgical or laser treatments or other pathologies (other than glaucoma and ERM) were excluded. RESULTS A total of 50 eyes (40 patients) were included in this study. The mean follow-up time after surgery was 27.8 months. After surgery, 9 eyes (18%) had preretinal macular fibrosis and 19 eyes (38%) had cellophane macular reflex. Of the 16 eyes with a preoperative macular SD-OCT, 3 (18.8%) developed ERM and 4 (25%) progressed from cellophane macular reflex to preretinal macular fibrosis, after surgery. The ERM frequency did not differ significantly between eyes subjected to trabeculectomy with or without the use of antimetabolites (P=0.08), or between eyes subjected to simple or combined surgery (phacotrabeculectomy) (P=0.09). CONCLUSION Trabeculectomy may predispose one to the appearance and progression of ERM. Further studies are needed to clarify this intriguing relation.
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Affiliation(s)
- Luísa Vieira
- *Department of Ophthalmology, Central Lisbon Hospital Center †Institute of Pharmacology and Neurosciences, Faculty of Medicine, University of Lisbon ‡NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
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THE EFFECT OF INTERNAL LIMITING MEMBRANE PEELING ON IDIOPATHIC EPIRETINAL MEMBRANE SURGERY, WITH A REVIEW OF THE LITERATURE. Retina 2017; 37:873-880. [PMID: 27617536 DOI: 10.1097/iae.0000000000001263] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine the effect of internal limiting membrane (ILM) removal on epiretinal membrane (ERM) surgery by comparing best-corrected visual acuity (BCVA), optical coherence tomography central macular thickness (CMT) changes, ERM recurrence, and need for repeat surgery. METHODS Retrospective study of 251 consecutive patients (251 eyes) who underwent pars plana vitrectomy for idiopathic ERM by a single surgeon with over 1 year of follow-up data. Data were collected preoperatively and postoperatively at 3 months, 1 year, 2 years, and at the last visit. The ILM was not specifically removed in the earlier group of patients and was removed after staining of the ILM in the later group. RESULTS One hundred and forty eyes (55.8%) did not have an ILM peel (non-ILM group), and 111 eyes (44.2%) did have an ILM peel (ILM group). There were no significant differences between groups in age, gender, preoperative BCVA, preoperative intraocular pressure, preoperative CMT on optical coherence tomography, and cataract status. Total follow-up time for the ILM group was 32.1 months and 45.4 months for the non-ILM group (P = 0.002). Both groups had improvement in BCVA. The ILM group improved by 12 Early Treatment Diabetic Retinopathy Study letters and the non-ILM group improved by 10.5 Early Treatment Diabetic Retinopathy Study letters. There was no significant difference in the final BCVA (P = 0.18) or total change of BCVA (P = 0.48). Cataract status preoperatively did not affect the total change of BCVA, but being phakic at the most recent visit was associated with a slight loss of visual acuity. Both groups had improvement in optical coherence tomography appearance, for the CMT in the ILM group decreased by 83 μm and the CMT in the non-ILM group decreased by 110 μm. There was no significant difference in the final CMT (P = 0.07); however, the non-ILM group tended to have a lower final CMT. Some degree of ERM recurrence was detected by slit-lamp biomicroscopy in 2 eyes (1.8%) of the ILM group and in 32 eyes (22.9%) of the non-ILM group (P ≤ 0.0001). None of the eyes with ILM removal required repeat vitrectomy, whereas 17 eyes (12.1%) of the non-ILM group did require vitrectomy, showing that ILM removal had a significant effect on the need for repeat vitrectomy (P < 0.0001) between non-ILM versus ILM peel groups. CONCLUSION The rate of recurrent ERM and need for repeat ERM surgery is lower in eyes where the ILM is removed with the ERM, whereas BCVA and CMT were similar with or without ILM removal. Complete ILM removal around the macula should be considered for the treatment of eyes with idiopathic ERMs to reduce the incidence of ERM recurrences.
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183
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Xiao W, Chen X, Yan W, Zhu Z, He M. Prevalence and risk factors of epiretinal membranes: a systematic review and meta-analysis of population-based studies. BMJ Open 2017; 7:e014644. [PMID: 28951399 PMCID: PMC5623383 DOI: 10.1136/bmjopen-2016-014644] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study was to aggregate the prevalence and risks of epiretinal membranes (ERMs) and determine the possible causes of the varied estimates. DESIGN Systematic review and meta-analysis. DATA SOURCES The search strategy was designed prospectively. We searched PubMed, Embase and Web of Science databases from inception to July 2016. Reference lists of the included literatures were reviewed as well. STUDY SELECTION Surveys published in English language from any population were included if they had a population-based design and reported the prevalence of ERM from retinal photography with or without optical coherence tomography. Eligibility and quality evaluation was conducted independently by two investigators. DATA EXTRACTION The literature search generated 2144 records, and 13 population-based studies comprising 49 697 subjects were finally included. The prevalence of ERM and the ORs of potential risk factors (age, sex, myopia, hypertension and so on) were extracted. RESULTS The pooled age-standardised prevalence estimates of earlier ERM (cellophane macular reflex (CMR)), advanced ERM (preretinal macular fibrosis (PMF)) and any ERM were 6.5% (95% CI 4.2% to 8.9%), 2.6% (95% CI 1.8% to 3.4%) and 9.1% (95% CI 6.0% to 12.2%), respectively. In the subgroup analysis, race and photography modality contributed to the variation in the prevalence estimates of PMF, while the WHO regions and image reading methods were associated with the varied prevalence of CMR and any ERM. Meta-analysis showed that only greater age and female significantly conferred a higher risk of ERMs. CONCLUSIONS Our findings suggest that ERMs are relatively common among aged population. Race, image taking and reading methodology may play important roles in influencing the large variability of ERM prevalence estimates.
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Affiliation(s)
- Wei Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyun Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - William Yan
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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Applewhite BP, Babapoor-Farrokhran S, Poon D, Hassan SJ, Wellmann E, Ying HS, Semenza GL, Montaner S, Sodhi A. Lack of Evidence for Vasoactive and Inflammatory Mediators in the Promotion of Macular Edema Associated with Epiretinal Membranes. Sci Rep 2017; 7:10608. [PMID: 28878218 PMCID: PMC5587698 DOI: 10.1038/s41598-017-08997-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 07/14/2017] [Indexed: 01/14/2023] Open
Abstract
The development of symptoms in patients with epiretinal membranes (ERMs) often corresponds with the accumulation of interstitial fluid in the retina [i.e., the development of macular edema, (ME)]. To explore the potential value of pharmacologic therapeutic options to treat ME in patients with ERMs, we examine here the expression of vasoactive and inflammatory mediators in the vitreous of patients with idiopathic ERMs. We observed that vitreous concentrations of classic vasoactive factors (e.g., vascular endothelial growth factor) were similar in ERM patients with ME compared to controls. Using an array assessing the expression of 102 inflammatory cytokines we similarly did not observe a marked difference in cytokine expression in the vitreous of most ERM patients with ME compared to control patients. While the array data did implicate a group of inflammatory cytokines that were elevated in a subset of ERM patients who had severe ME (central subfield thickness ≥450 μm on spectral domain optical coherence tomography), expression of 3 of these inflammatory cytokines, all previously implicated in the promotion of ME in ischemic retinal disease, were not elevated by quantitative enzyme-linked immunosorbent assay. We conclude that therapies modulating vasoactive mediators or inflammatory cytokines may not affect ME in ERM patients.
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Affiliation(s)
- Brooks P. Applewhite
- 0000 0001 2171 9311grid.21107.35Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Savalan Babapoor-Farrokhran
- 0000 0001 2171 9311grid.21107.35Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - David Poon
- 0000 0001 2171 9311grid.21107.35Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Syed Junaid Hassan
- 0000 0001 2171 9311grid.21107.35Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Elizabeth Wellmann
- 0000 0001 2171 9311grid.21107.35Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Howard S. Ying
- 0000 0004 0367 5222grid.475010.7Department of Ophthalmology, Boston University School of Medicine, Boston, MA 02346 USA
| | - Gregg L. Semenza
- 0000 0001 2171 9311grid.21107.35Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland United States ,0000 0001 2171 9311grid.21107.35Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States ,0000 0001 2171 9311grid.21107.35Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland United States ,0000 0001 2171 9311grid.21107.35Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland United States ,0000 0001 2171 9311grid.21107.35Department of Biological Chemistry, Johns Hopkins University School of Medicine, Baltimore, Maryland United States ,0000 0001 2171 9311grid.21107.35McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland United States
| | - Silvia Montaner
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland United States ,0000 0001 2175 4264grid.411024.2Department of Pathology, School of Medicine, University of Maryland, Baltimore, Maryland, United States ,0000 0001 2175 4264grid.411024.2Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland, United States
| | - Akrit Sodhi
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
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185
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Kim JM, Lee H, Shin JP, Ahn J, Yoo JM, Song SJ, Kim SJ, Kang SW. Epiretinal Membrane: Prevalence and Risk Factors from the Korea National Health and Nutrition Examination Survey, 2008 through 2012. KOREAN JOURNAL OF OPHTHALMOLOGY 2017; 31:514-523. [PMID: 29022294 PMCID: PMC5726986 DOI: 10.3341/kjo.2016.0098] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 01/13/2017] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the prevalence and risk factors for an epiretinal membrane (ERM) in Korean population. METHODS Using the database of the Korea National Health and Nutrition Examination Survey from 2008 through 2012, 14,772 participants 40 years of age or older with gradable fundus photographs were included. The presence of ERM was determined by using fundus photographs. The prevalence of ERM was estimated and possible risk factors including systemic factors, nutritional status, and blood tests were analyzed via multiple logistic regression analyses. RESULTS The prevalence of ERM was 2.9% (95% confidence interval [CI], 2.6% to 3.3%). On multiple logistic regression analysis, the prevalence of ERM was affected by age. The odds ratios (ORs) against the forties were 2.70, 5.48, and 5.69 in the fifties, sixties, and seventies, respectively. ERM was also significantly affected by cataract surgery (OR, 2.82; 95% CI, 2.08 to 3.81) and by the increase in intake of 100-mg calcium (OR, 1.05; 95% CI, 1.00 to 1.11). ERM had negative associations with red blood cell count (OR, 0.66; 95% CI, 0.45 to 0.95). CONCLUSIONS The estimated nation-wide prevalence of ERM in Korea is 2.9%. The presence of ERM in the general population is associated with age, cataract surgery, increased dietary calcium, and a low red blood cell count.
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Affiliation(s)
- Jong Min Kim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hoyoung Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Pil Shin
- Department of Ophthalmology, Kyungpook National University Hospital, Daegu, Korea
| | - Jeeyun Ahn
- Department of Ophthalmology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Je Moon Yoo
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Su Jeong Song
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Jin Kim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Woong Kang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Hoerauf H, Kirchhof B. [Watchful waiting as a therapeutic principle for diseases of the vitreoretinal interface]. Ophthalmologe 2017; 114:1042-1049. [PMID: 28812133 DOI: 10.1007/s00347-017-0549-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Elective surgery of the vitreoretinal interface is currently the most common reason for vitrectomy in Germany. The evaluation and correct interpretation of spectral domain optical coherence tomography (SD-OCT) images is of great importance but the indications for vitrectomy in macular surgery should be based more on patient symptoms and not only the OCT findings. Watchful waiting is highlighted as an alternative therapeutic option in individual patients. This article addresses a number of aspects and discrepancies between findings and patients' level of suffering based on binocular symptoms. Postoperative retinal thickening and irregular surface of the macula after peeling operations may still allow excellent function and often require no therapeutic measures. The difficulties in differentiating between cystoid macular edema after cataract operations with simultaneous epiretinal gliosis and gliosis as the cause of macular edema are highlighted.
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Affiliation(s)
- H Hoerauf
- Augenklinik der Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
| | - B Kirchhof
- Abteilung für Netzhaut- und Glaskörperchirurgie, Zentrum für Augenheilkunde, Universität zu Köln, Köln, Deutschland
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187
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Wertheimer C, Eibl-Lindner KH, Compera D, Kueres A, Wolf A, Docheva D, Priglinger SG, Priglinger C, Schumann RG. A cell culture technique for human epiretinal membranes to describe cell behavior and membrane contraction in vitro. Graefes Arch Clin Exp Ophthalmol 2017; 255:2147-2155. [DOI: 10.1007/s00417-017-3767-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 03/08/2017] [Accepted: 07/25/2017] [Indexed: 11/29/2022] Open
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Sauer L, Peters S, Schmidt J, Schweitzer D, Klemm M, Ramm L, Augsten R, Hammer M. Monitoring macular pigment changes in macular holes using fluorescence lifetime imaging ophthalmoscopy. Acta Ophthalmol 2017; 95:481-492. [PMID: 27775222 DOI: 10.1111/aos.13269] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 08/12/2016] [Indexed: 01/19/2023]
Abstract
PURPOSE To investigate the impact of macular pigment (MP) on fundus autofluorescence (FAF) lifetimes in vivo by characterizing full-thickness idiopathic macular holes (MH) and macular pseudo-holes (MPH). METHODS A total of 37 patients with MH and 52 with MPH were included. Using the fluorescence lifetime imaging ophthalmoscope (FLIO), based on a Heidelberg Engineering Spectralis system, a 30° retinal field was investigated. FAF decays were detected in a short (498-560 nm; ch1) and long (560-720 nm; ch2) wavelength channel. τm , the mean fluorescence lifetime, was calculated from a three-exponential approximation of the FAF decays. Macular coherence tomography scans were recorded, and macular pigment's optical density (MPOD) was measured (one-wavelength reflectometry). Two MH subgroups were analysed according to the presence or absence of an operculum above the MH. A total of 17 healthy fellow eyes were included. A longitudinal FAF decay examination was conducted in nine patients, which were followed up after surgery and showed a closed MH. RESULTS In MH without opercula, significant τm differences (p < 0.001) were found between the hole area (MHa) and surrounding areas (MHb) (ch1: MHa 238 ± 64 ps, MHb 181 ± 78 ps; ch2: MHa 275 ± 49 ps, MHb 223 ± 48 ps), as well as between MHa and healthy eyes or closed MH. Shorter τm , adjacent to the hole, can be assigned to areas with equivalently higher MPOD. Opercula containing MP also show short τm . In MPH, the intactness of the Hele fibre layer is associated with shortest τm . CONCLUSIONS Shortest τm originates from MP-containing retinal layers, especially from the Henle fibre layer. Fluorescence lifetime imaging ophthalmoscope (FLIO) provides information on the MP distribution, the pathogenesis and topology of MH. Macular pigment (MP) fluorescence may provide a biomarker for monitoring pathological changes in retinal diseases.
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Affiliation(s)
- Lydia Sauer
- Department of Ophthalmology; University Hospital Jena; Jena Germany
| | - Sven Peters
- Department of Ophthalmology; University Hospital Jena; Jena Germany
| | - Johanna Schmidt
- Department of Ophthalmology; University Hospital Jena; Jena Germany
| | | | - Matthias Klemm
- Institute of Biomedical Engineering and Informatics; Technical University Ilmenau; Ilmenau Germany
| | - Lisa Ramm
- Department of Ophthalmology; University Hospital Carl-Gustav Carus; TU Dresden Germany
| | - Regine Augsten
- Department of Ophthalmology; University Hospital Jena; Jena Germany
| | - Martin Hammer
- Department of Ophthalmology; University Hospital Jena; Jena Germany
- Center for Medical Optics and Photonics; University of Jena; Jena Germany
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189
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Chang WC, Lin C, Lee CH, Sung TL, Tung TH, Liu JH. Vitrectomy with or without internal limiting membrane peeling for idiopathic epiretinal membrane: A meta-analysis. PLoS One 2017. [PMID: 28622372 PMCID: PMC5473547 DOI: 10.1371/journal.pone.0179105] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Studies on vitrectomy with and without internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (ERM) have yielded uncertain results regarding clinical outcomes and recurrence rates. OBJECTIVE To compare the clinical outcomes of vitrectomy with and without ILM peeling for idiopathic ERM. METHODS Databases, including PubMed, Embase, Cochrane, Web of Science, Google Scholar, CNKI databases, FDA.gov, and ClinicalTrials.gov, published until July 2016, were searched to identify studies comparing the clinical outcomes following vitrectomy with ERM and ILM peeling and with only ERM peeling, for treating idiopathic ERM. Studies with sufficient data were selected. Pooled results were expressed as mean differences (MDs) and risk ratios (RRs) with corresponding 95% confidence intervals (CI) for vitrectomy with and without ILM peeling with regard to postoperative best corrected visual acuity (BCVA), central retinal thickness (CRT), and ERM recurrence rate. RESULTS Eleven retrospective studies and one randomized controlled trial involving 756 eyes were identified. This demonstrated that the postoperative BCVA within 12 months was significantly better in the non-ILM peeling group (MD = 0.04, 95% CI: 0.00 to 0.08; P = 0.0460), but that the patients in the ILM peeling group had significantly better postoperative BCVA after 18 months (MD = -0.13, 95% CI: -0.23 to -0.04; P = 0.0049) than did those in the non-ILM peeling group. The non-ILM peeling group exhibited a higher reduction in postoperative CRT (MD = 51.55, 95% CI:-84.23 to -18.88; P = 0.0020) and a higher recurrence rate of ERM (RR = 0.34, 95% CI:0.16 to 0.72; P = 0.0048) than did the ILM peeling group. However, the improvement rates of BCVA (RR = 1.03, 95% CI:0.72 to 1.47; P = 0.8802) and postoperative CRTs (MD = 18.15, 95% CI:-2.29 to 38.60; P = 0.0818) were similar between the two groups. CONCLUSIONS Vitrectomy with ILM peeling results in better visual improvement in long-term follow-ups and lower ERM recurrence rates, and vitrectomy with only ERM peeling is more efficacious in reduction of CRT than is vitrectomy with ILM peeling.
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Affiliation(s)
- Wei-Cheng Chang
- Department of Ophthalmology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Chin Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Cho-Hao Lee
- Department of InternalMedicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tzu-Ling Sung
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tao-Hsin Tung
- Department of Medical Research and Education, Cheng Hsin General Hospital, Taipei, Taiwan
- Faculty of Public Health, School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
| | - Jorn-Hon Liu
- Department of Ophthalmology, Cheng Hsin General Hospital, Taipei, Taiwan
- * E-mail:
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Dikkaya F, Karaman Erdur S, Ozsutcu M, Aydin R, Kocabora MS, Aras C. The significance of neutrophil-to-lymphocyte ratio in idiopathic epiretinal membrane. Int Ophthalmol 2017; 38:1393-1397. [PMID: 28608032 DOI: 10.1007/s10792-017-0597-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/05/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the levels of neutrophil-to-lymphocyte ratio (NLR) in patients with idiopathic epiretinal membrane (iERM) and to compare the NLR results of patients with iERM and healthy controls. METHODS This retrospective study enrolled 43 patients with iERM and 40 healthy subjects. Complete ophthalmologic examination and complete blood count measurements were performed of all subjects. Complete blood counts were performed within 2 h of blood collection. RESULTS There was a significant difference in NLR between iERM and control groups (p < 0.01). The receiver operating characteristics analysis revealed that the value of NLR to distinguish patients with iERM and controls was found to be 0.832. The best cutoff value was 1.90, with a sensitivity of 72% and specificity 70%. CONCLUSIONS Our study for the first time provides evidence that subclinical systemic inflammation may cause or at least accompanies iERM using a novel biomarker NLR.
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Affiliation(s)
- Funda Dikkaya
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, 34214, Turkey
| | - Sevil Karaman Erdur
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, 34214, Turkey.
| | - Mustafa Ozsutcu
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, 34214, Turkey
| | - Rukiye Aydin
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, 34214, Turkey
| | | | - Cengiz Aras
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, 34214, Turkey
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191
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Cho HJ, Kim JM, Kim HS, Lee DW, Kim CG, Kim JW. Effect of Epiretinal Membranes on Antivascular Endothelial Growth Factor Treatment for Neovascular Age-Related Macular Degeneration. J Ocul Pharmacol Ther 2017; 33:452-458. [PMID: 28445077 DOI: 10.1089/jop.2016.0178] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To evaluate the effect of epiretinal membranes (ERMs), detected with spectral-domain optical coherence tomography (SD-OCT), on the outcome of antivascular endothelial growth factor (VEGF) treatment for neovascular age-related macular degeneration (nAMD). METHODS A total of 434 eyes with treatment-naive nAMD were retrospectively included and analyzed. All patients were administered an initial series of 3 monthly loading injections of ranibizumab or aflibercept, followed by further injections as required. The visual and anatomical outcomes were compared between the eyes with ERMs and those without. Features of ERMs at baseline assessed with SD-OCT were evaluated and correlated with visual outcomes. RESULTS Sixty-eight eyes (15.7%) with nAMD presented ERMs at baseline. The mean best-corrected visual acuity (BCVA) of these eyes, expressed as the logarithm of the minimum angle of resolution, improved from 0.75 ± 0.48 (Snellen equivalent: 20/112) to 0.59 ± 0.44 (20/77) after 12 months of treatment (P = 0.021). Central foveal thickness also decreased from 381 ± 191 μm to 294 ± 167 μm (P < 0.001). Compared to the eyes without ERMs (366 eyes), the eyes with ERMs had a significantly thicker central fovea after treatment (P = 0.020). However, the intergroup differences in BCVA improvement were not significant. No significant association was found between visual outcome after treatment and ERM features on OCT at baseline. CONCLUSIONS In eyes with nAMD, ERMs were infrequent. Central foveal thickness was significantly greater after anti-VEGF treatment in eyes with nAMD and ERMs. However, the presence of ERMs in eyes with nAMD did not affect visual outcome.
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Affiliation(s)
- Han Joo Cho
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine , Seoul, South Korea
| | - Jae Min Kim
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine , Seoul, South Korea
| | - Hyoung Seok Kim
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine , Seoul, South Korea
| | - Dong Won Lee
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine , Seoul, South Korea
| | - Chul Gu Kim
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine , Seoul, South Korea
| | - Jong Woo Kim
- Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine , Seoul, South Korea
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192
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Ali FS, Stein JD, Blachley TS, Ackley S, Stewart JM. Incidence of and Risk Factors for Developing Idiopathic Macular Hole Among a Diverse Group of Patients Throughout the United States. JAMA Ophthalmol 2017; 135:299-305. [PMID: 28208188 DOI: 10.1001/jamaophthalmol.2016.5870] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Importance Idiopathic macular holes (MHs) are a cause of decreased vision among older Americans. A better understanding of risk factors for MH may help clarify the pathophysiologic factors of MH and identify potential new avenues for preventing and treating idiopathic MHs. Objective To determine the incidence of and risk factors associated with the development of idiopathic MH requiring surgical repair with vitrectomy among a large group of managed care plan beneficiaries throughout the United States. Design, Setting, and Participants A retrospective, longitudinal cohort study was conducted of all beneficiaries 40 years or older who were continuously enrolled for 3 or more years in a nationwide US managed care network between January 1, 2001, and December 31, 2012, who had 2 or more visits to an eye care professional. The managed care network was queried starting in 2009, and data analysis was conducted from December 1, 2014, to August 15, 2016. Main Outcomes and Measures Development of idiopathic MH requiring surgical repair with vitrectomy. Results Of the 659 357 enrollees who met inclusion criteria (391 674 females and 267 683 males; mean [SD] age, 56.2 [9.2] years), 144 (0.02%) developed an MH requiring vitrectomy. After adjusting for confounding factors, females had a 64% increased risk of developing MH compared with males (adjusted hazard ratio, 1.64; 95% CI, 1.11-2.43; P = .01), with the effect of sex varying across ages. Compared with white participants, Asian-American enrollees had a 177% increased risk of developing MH (adjusted hazard ratio, 2.77; 95% CI, 1.27-6.02; P = .01). Conclusions and Relevance In this large cohort, sex was confirmed to be associated with developing an MH requiring vitrectomy; the effect varies across ages differently for females vs males. These differences may be the basis for the underlying pathophysiologic factors contributing to the development of MH.
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Affiliation(s)
- Ferhina S Ali
- Department of Ophthalmology, University of California, San Francisco
| | - Joshua D Stein
- Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor3Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor4School of Public Health, Department of Health Management and Policy, University of Michigan, Ann Arbor
| | - Taylor S Blachley
- Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor
| | - Sarah Ackley
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Jay M Stewart
- Department of Ophthalmology, University of California, San Francisco
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193
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Nava U, Cereda MG, Bottoni F, Preziosa C, Pellegrini M, Giani A, Staurenghi G. Long-term follow-up of fellow eye in patients with lamellar macular hole. Graefes Arch Clin Exp Ophthalmol 2017; 255:1485-1492. [PMID: 28405744 DOI: 10.1007/s00417-017-3652-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/11/2017] [Accepted: 03/20/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND To evaluate macular changes in fellow eyes of patients diagnosed with lamellar macular hole (LMH) using spectral-domain optical coherence tomography (SD-OCT) and blue fundus autofluorescence (B-FAF). METHODS Fellow eyes of patients diagnosed with a LMH were retrospectively evaluated on OCT. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were recorded. Corresponding B-FAF images, vitreo-macular relations, and type of epiretinal membranes (ERMs) were also examined. RESULTS Thirty-five patients were included. At baseline, six fellow eyes (17%) showed a normal foveal profile, 26 (74%) had a tractional ERM, and three cases (9%) revealed a bilateral LMH, one of them with a lamellar hole-associated epiretinal proliferation (LHEP). A posterior vitreous detachment (PVD) was present in 29 patients (83%), four (11%) had only a vitreo-papillary adhesion (VPA), and two (6%) had both vitreo-macular adhesion (VMA) and VPA. After a mean follow-up of 4.6 ± 1.9 years, one eye (3%) developed a vitreous detachment from the macula with persistent VPA, and one developed a PVD from a VPA with subsequent ERM formation. BCVA and mean CFT remained stable in 35 eyes (100%). Likewise, no B-FAF signal variations were detected. One patient developed a LMH during the 3rd year of follow-up. CONCLUSIONS Our data suggest that the presence of a LMH in one eye does not increase significantly the risk of developing the same condition in the fellow eye after 4 years. Bilateral condition is uncommon, and an ERM is often detected in the fellow eye. LHEPs were not observed in fellow eyes with foveal integrity, and all LHEPs observed (in main and fellow eyes) were always associated with LMHs; this supports the hypothesis that LHEP is a consequence and not a causative factor for LMHs. The occurrence of a LMH in one fellow eye after 3 years follow-up may suggest that a higher incidence of bilateral disease could develop in a longer time span.
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Affiliation(s)
- Ugo Nava
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Via G.B. Grassi 74, Milano, MI, Italy.
| | - Matteo Giuseppe Cereda
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Via G.B. Grassi 74, Milano, MI, Italy
| | - Ferdinando Bottoni
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Via G.B. Grassi 74, Milano, MI, Italy
| | - Chiara Preziosa
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Via G.B. Grassi 74, Milano, MI, Italy
| | - Marco Pellegrini
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Via G.B. Grassi 74, Milano, MI, Italy
| | - Andrea Giani
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Via G.B. Grassi 74, Milano, MI, Italy
| | - Giovanni Staurenghi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Via G.B. Grassi 74, Milano, MI, Italy
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194
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Fang XL, Tong Y, Zhou YL, Zhao PQ, Wang ZY. Internal limiting membrane peeling or not: a systematic review and meta-analysis of idiopathic macular pucker surgery. Br J Ophthalmol 2017; 101:1535-1541. [DOI: 10.1136/bjophthalmol-2016-309768] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/17/2017] [Accepted: 02/21/2017] [Indexed: 11/04/2022]
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195
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EPIRETINAL MEMBRANE IN NONEXUDATIVE AGE-RELATED MACULAR DEGENERATION: Anatomical Features, Visual Outcomes and Prognostic Factors. Retina 2017; 36:1557-65. [PMID: 27456023 DOI: 10.1097/iae.0000000000000953] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate clinical characteristics, assess surgical outcomes, and determine prognostic factors after vitrectomy for epiretinal membrane (ERM) associated with nonexudative age-related macular degeneration (AMD). METHODS This study comprised 171 consecutive patients with idiopathic ERM (n = 132) or nonexudative AMD-associated ERM (AMD-ERM, n = 39) undergoing vitrectomy. Preoperative morphologic characteristics on spectral-domain optical coherence tomography images and postoperative outcomes of the two groups were compared. Factors influencing postoperative best-corrected visual acuity in the AMD-ERM group were also analyzed. RESULTS The AMD-ERM group was more likely to have an ERM with a smooth appearance (P = 0.009), a less severe vessel traction score (P = 0.002), a thinner central foveal thickness (P = 0.016), and more photoreceptor disruption than idiopathic ERM group. Mean central foveal thickness improved from 404.92 ± 82.08 and 369.87 ± 68.17 μm at baseline to 339.77 ± 39.27 and 331.72 ± 45.76 μm 1 year after surgery in eyes with idiopathic ERM and AMD-ERM, respectively (all P < 0.001). Mean logarithm of the minimum angle of resolution best-corrected visual acuity improved from 0.30 (20/40) ± 0.21 and 0.32 (20/42) ± 0.18 at baseline to 0.02 (20/21) ± 0.09 and 0.13 (20/27) ± 0.17 1 year after surgery in the idiopathic ERM and AMD-ERM groups, respectively (all P < 0.001). Baseline integrity of the ellipsoid zone line (P = 0.009) and preoperative best-corrected visual acuity (P = 0.024) were significantly correlated with visual outcome in the AMD-ERM group. CONCLUSION Morphologic differences between AMD-ERM and idiopathic ERM were identified. Vitrectomy resulted in significant anatomical and visual improvements in eyes with AMD-ERM, but final visual outcome was worse in these eyes than in those with idiopathic ERM.
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196
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Govetto A, Lalane RA, Sarraf D, Figueroa MS, Hubschman JP. Insights Into Epiretinal Membranes: Presence of Ectopic Inner Foveal Layers and a New Optical Coherence Tomography Staging Scheme. Am J Ophthalmol 2017; 175:99-113. [PMID: 27993592 DOI: 10.1016/j.ajo.2016.12.006] [Citation(s) in RCA: 259] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/05/2016] [Accepted: 12/07/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To describe the presence of continuous ectopic inner foveal layers associated with epiretinal membranes (ERMs) and to present a new optical coherence tomography (OCT) staging system of ERMs. DESIGN Retrospective multicenter observational case series. METHODS Clinical charts and spectral-domain OCT images of 194 eyes of 172 consecutive patients diagnosed with ERMs were reviewed and analyzed. RESULTS The presence of continuous ectopic inner foveal layers was identified in 63 out of 194 eyes (32.5%) and this morphology was significantly associated with lower visual acuity. ERMs were divided into 4 stages. Stage 1 (43 out of 194 eyes, 22.1%) ERMs were mild and thin and a foveal depression was present. Stage 2 (88 out of 194 eyes, 45.4%) ERMs were associated with widening of the outer nuclear layer and loss of the foveal depression. Stage 3 (51 out of 194 eyes, 26.3%) ERMs were associated with continuous ectopic inner foveal layers crossing the entire foveal area. In stages 1, 2, and 3 all retinal layers were clearly defined on OCT. Stage 4 ERMs (12 out of 194 eyes, 6.2%) were thick and associated with continuous ectopic inner foveal layers. In addition, retinal layers were disrupted. Visual acuity progressively declined from stage 1 through stage 4 (P < .001). CONCLUSIONS The presence of continuous ectopic inner foveal layers in ERMs is a newly described OCT finding associated with significant vision loss and is an essential element of a novel OCT-based grading scheme of ERMs that may influence visual prognosis.
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197
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Miliatos I, Lindgren G. Epiretinal membrane surgery evaluated by subjective outcome. Acta Ophthalmol 2017; 95:52-59. [PMID: 27041544 DOI: 10.1111/aos.13001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 12/29/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To examine pre- and postoperative visual interference, subjective symptoms and visual acuity in patients undergoing epiretinal membrane (ERM) surgery. METHODS A retrospective observational case series comparing 239 eyes in 231 consecutive patients with idiopathic ERM in a selected catchment area from 2002 to 2009. Demography, visual acuity (VA), lens status and subjective symptoms were analysed before and after the operation. Patients, healthy enough to participate at least 2 years post surgery, answered a questionnaire about their subjective functional impairment before and after the ERM peeling. Visual disturbance was assessed on a visual analogue scale (VAS) ranging from 1 to 100 mm. RESULTS The preoperative VA for the eyes in the study was median 0.40 logMAR (logarithm of the minimum angle of resolution) (range -0.1 to 1.22) resulted in VA of 0.22 logMAR (range -0.1 to 1.1), which is a statistical significant difference (p -). Of 180 patients contacted, answers were received from 103 (57%). Subjective visual disturbance assessed on the VAS showed a median of 70 mm (range 0-100) before surgery compared to a subjective disturbance median 27 mm (range 0-98) postoperatively. The change preoperatively to postoperatively was mean -34 mm (SD 31), median -37 (range -96 to 37), p -. Patients with much disturbance at baseline measured by VAS experienced more subjective benefit of the operation measured by the distance between the mark on the VAS preoperatively and postoperatively, p -, Spearman correlation coefficient. CONCLUSION Patients with considerable preoperative disturbance benefit more from an operation than those with less disturbance.
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Affiliation(s)
| | - Gun Lindgren
- Department of Ophthalmology; Sahlgrenska University Hospital; University of Gothenburg; Gothenburg Sweden
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198
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Chang CK, Cheng CK, Peng CH. The incidence and risk factors for the development of vitreomacular interface abnormality in diabetic macular edema treated with intravitreal injection of anti-VEGF. Eye (Lond) 2017; 31:762-770. [PMID: 28106889 DOI: 10.1038/eye.2016.317] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 12/02/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo report the incidence and associated factors for the development of vitreomacular interface abnormality (VMIA) in patients with diabetic macular edema (DME) who received intravitreal injection (IVI) of anti-VEGF (Bevacizumab and Ranibizumab) treatment.MethodsA retrospective observational study. Patients with DME followed at least 6 months were reviewed. Baseline best-corrected visual acuity (BCVA), central retinal thickness (CRT) and final BCVA, CRT in eyes with and without VMIA were compared. Multiple logistic regression was also used to investigate the risk factors of VMIA formation in patients with DME treated by anti-VEGF.ResultsA total of 201 eyes in 142 patients met the inclusion criteria of the study. VMIA developed in 44 eyes (21.89%) of patients during a mean follow-up period of 40.84 months. The estimated mean incidence of VMIA formation was 6.43% per year. Poor baseline BCVA was found to be a risk factor for VMIA development (P=0.001, odds ratio=5.299, 95% confidence interval: 1.972 to 14.238). There was no difference between eyes with and without VMIA formation in improving BCVA (P=0.557) and lowering the macular edema (eyes without VMIA formation: -107.72±171.91 μm; eyes with VMIA formation: -155.02±212.27 μm, P=0.133).ConclusionsThis study revealed the incidence of VMIA formation in IVI anti-VEGF treated DME eyes was 6.43%. Poor baseline BCVA was found to be a risk factor for VMIA formation. Both eyes with and without VMIA development had favorable response to anti-VEGF treatment.
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Affiliation(s)
- C-K Chang
- Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - C-K Cheng
- Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,Department of Ophthalmology, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan.,Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - C-H Peng
- Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,Department of Ophthalmology, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan
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199
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Soluble form of LR11 is highly increased in the vitreous fluids of patients with idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2017; 255:885-891. [DOI: 10.1007/s00417-017-3585-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 12/24/2016] [Accepted: 01/04/2017] [Indexed: 12/11/2022] Open
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200
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Hejsek L, Stepanov A, Dohnalova A, Rehakova T, Jiraskova N. The natural evolution of idiophatic epimacular membrane. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2017; 161:100-106. [PMID: 28096551 DOI: 10.5507/bp.2016.065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 12/19/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND AIMS Epiretinal membrane (ERM) refers to a semi-translucent tissue layer found on the inner surface of the retina especially in older people. Surgical treatment remains controversial, optimal timing for such treatment is difficult to determine and data on the natural evolution of this disorder are limited. In this study we evaluated the natural course of idiopathic epimacular membrane in 49 patients (53 eyes). MATERIALS AND METHODS Retrospective evaluation of a group of 49 patients (53 eyes) with idiopathic epimacular membrane confirmed by biomicroscopy, photography and optical coherence tomography (OCT). RESULTS Patient age ranged from 51-85 years (median 72). The average follow-up was 21.3 months (± 14). Between the initial and final best corrected visual acuity (BCVA) there was no statistically significant difference although there was a significant tendency to decrease in BCVA (Spearman P=0.05) during the follow-up. Initial BCVA correlated with initial central retinal thickness (CRT), final CRT, final volume, and age. The final BCVA significantly correlated with all parameters measured. CONCLUSION BCVA during follow-up tended to decrease: difference of starting BCVA and final BCVA values depending on the time of monitoring is significant. This we attribute to a slow gradual progression of macular changes. But, initial and final BCVA measurements were not substantially different at the end. Thus, in the absence of any clear signs of ERM progression, we can safely postpone the decision whether to perform PPV.
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Affiliation(s)
- Libor Hejsek
- Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic
| | - Alexandr Stepanov
- Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic
| | - Alena Dohnalova
- Institute of Physiology, 1st Faculty of Medicine, Charles University in Prague, Czech Republic
| | - Tereza Rehakova
- Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic
| | - Nada Jiraskova
- Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic
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