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Long-term natural history of idiopathic epiretinal membranes with good visual acuity.

Long-term natural history of idiopathic epiretinal membranes with good visual acuity.

Authors :
Luu KY
Koenigsaecker T
Yazdanyar A
Mukkamala L
Durbin-Johnson BP
Morse LS
Moshiri A
Park SS
Yiu G
Source :
Eye (London, England) [Eye (Lond)] 2019 May; Vol. 33 (5), pp. 714-723. Date of Electronic Publication: 2019 Apr 19.
Publication Year :
2019

Abstract

Background/objectives: To evaluate the long-term progression of idiopathic epiretinal membranes (iERMs) with good baseline visual acuity, and to identify predictors of visual decline.<br />Design: Retrospective case series SUBJECTS METHODS: We reviewed records of 145 eyes with iERM and best-corrected visual acuity (BCVA) of 20/40 or greater at presentation, including BCVA, lens status, and central macular thickness (CMT) at yearly visits; as well as anatomic biomarkers including vitreomacular adhesion, pseudohole, lamellar hole, intraretinal cysts, disorganization of the inner retinal layers (DRIL), and disruption of outer retinal layers. Linear mixed effects and mixed-effects Cox proportional hazards models were used to identify clinical and anatomic predictors of vision change and time to surgery.<br />Results: At presentation, mean BCVA was 0.17 ± 0.10 logMAR units (Snellen 20/30) and mean CMT was 353.3 ± 75.4 μm. After a median follow-up of 3.7 years (range 1-7 years), BCVA declined slowly at 0.012 ± 0.003 logMAR units/year, with phakic eyes declining more rapidly than pseudophakic eyes (0.019 ± 0.003 vs. 0.010 ± 0.004 logMAR units/year). Metamorphopsia, phakic lens status, lamellar hole, and inner nuclear layer cysts were associated with faster visual decline. Cumulative rates of progression to surgery were 2.9, 5.6, 12.2, and 21.1% at years 1-4. Visual symptoms, metamorphopsia, greater CMT, and disruption of outer retinal layers were associated with greater hazard for surgery.<br />Conclusion: Eyes with iERM and visual acuity ≥ 20/40 experience slow visual decline, with 21% of eyes requiring surgery after 4 years. Clinical and anatomic predictors of vision loss may be distinct from factors associated with earlier surgical intervention.

Details

Language :
English
ISSN :
1476-5454
Volume :
33
Issue :
5
Database :
MEDLINE
Journal :
Eye (London, England)
Publication Type :
Academic Journal
Accession number :
31000833
Full Text :
https://doi.org/10.1038/s41433-019-0397-z