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Adam Rothman, Francisco Folgar, Amy Tong, Cynthia Toth; A Comparison of Macular Morphology of Pediatric Versus Adult Eyes with Epiretinal Membranes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2812.
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© ARVO (1962-2015); The Authors (2016-present)
To compare macular morphology of children versus adults with epiretinal membrane (ERM) and identify whether children with ERM have unique anatomic characteristics.
An existing research database of adult and pediatric subjects imaged with an 840nm wavelength portable spectral domain optical coherence tomography (SDOCT) system was reviewed to yield 29 pediatric subjects who underwent ERM peel and an additional 6 pediatric subjects with clinically documented ERM. Thirteen pediatric subjects were excluded due to poor image quality or lack of pre-operative images. Two trained graders analyzed the SDOCT images of 1 eye per subject from 22 children and from 22 randomly selected adults who underwent surgical removal of ERM. Subjects were evaluated for demographics, quantitative measurements of anatomic features, and presence and deformation of retinal layers.
The mean age ± standard deviation of the children was 5.9 ± 5.2 years and of adults was 70 ± 11 years. Macular thickness was measurable in 18/22 children and 21/22 adults. Mean macular thickness of children and adults was 517 ± 245 µm and 485 ± 172 µm, p=0.644, respectively. In children versus adults, there was a significantly greater incidence of foveal sparing by ERM (6/20 vs 1/22, p=0.041) and a trend towards less foveal deformation (16/19 vs 22/22, p=0.091). Vessel dragging was more common in children than adults (15/22 vs 7/21, p=0.034). There were non-significant differences in incidences of external limiting membrane visibility and disruption, inner segment band disruption, retinal folds, depth of retina involved in folds, intraretinal cysts, and subretinal fluid between these groups; the differences will be characterized by group. Partial vitreous separation was noted in 9 of 21 children and 6 of 22 adults.
Significant macular morphologic differences in pediatric versus adult subjects with ERM include decreased foveal deformation, ERM absence at the fovea, and increased vessel dragging in children. Mean macular thickness does not differ between the two populations but does have a much larger standard deviation in the pediatric population. Vitreous separation was notably common in children with ERM and extended to a young age when examined by SDOCT. SDOCT allows for more accurate evaluation of the vitreoretinal interface in children with ERM and, as in adults, provides useful preoperative information.
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