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Sahar Bedrood, Linda Lam, Srinivas Sadda; Characteristics of epiretinal membranes which influence post-surgical visual outcomes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3311.
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To determine the characteristics of epiretinal membranes which predicted visual and anatomic outcomes following vitrectomy and membrane peeling.
We retrospectively reviewed the clinical records and imaging data from 95 patients with epiretinal membranes (ERM) who underwent pars plana vitrectomy and membrane peeling. To be included in this analysis, subjects had to have an ERM involving the central macula that resulted in vision less than 20/30, and a complete clinical record and SD-OCT volume scan obtained preoperatively and 1 and 2 month postoperatively. Exclusion criteria include the presence of any other retinal or visually significant disease. In addition to patient demographic data and duration of disease, retinal thickness, OCT characteristics of the ERM (reflectivity, thickness, type of attachment), and best-corrected visual acuity (BCVA) were collected at baseline and the follow-up visits. Pearson correlation was used to assess the association between baseline characteristics and 1 and 2 month post-surgical visual outcomes.
The average age of patients was 70 years and 73% were female. Average pre-operative BCVA was 20/47 (ratio 0.42 +/- 0.17). The mean pre-operative foveal central subfield (FCS) thickness as measured by SD-OCT was 425 um (SD +/- 64 um). The mean post-operative Month 2 BCVA was 20/38 (ratio 0.52 +/- 0.18) and the mean post-op Month 2 FCS thickness was 346 (SD +/- 0.44). Preoperative visual acuity and foveal thickness positively correlated with postoperative visual acuity and foveal thickness (r=0.18, 0.48, respectively). Additionally, we found the number of days between diagnosis and surgery demonstrated a weak negative correlation with post-operative visual acuity.
For patients with ERM, early membrane removal and higher preoperative visual acuity resulted in improved visual prognosis postoperatively. These findings support the notion that chronicity of ERM and delay to surgery can negatively impact the overall post-operative visual prognosis.
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