June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Prevalence and Risk Factors of Epiretinal membrane in the Multicenter Uveitis Steroid Treatment (MUST) Trial
Author Affiliations & Notes
  • Lyndell L Lim
    Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia
    Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
  • Francis Abreu
    Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
  • Elizabeth A Sugar
    Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
  • Alyce Burke
    Center for Clinical Trials, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
  • Michael M Altaweel
    Ophthalmology and Vision Sciences, University of Wisconsin, Madison, WI
  • P. Kumar Rao
    Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, MO
  • Janet T. Holbrook
    Center for Clinical Trials, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
  • Susan G Elner
    Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor, MI
  • Richard Stawell
    Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia
    Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
  • John H Kempen
    Ophthalmology Biostatistics & Epidemiology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA
  • Footnotes
    Commercial Relationships Lyndell Lim, None; Francis Abreu, None; Elizabeth Sugar, None; Alyce Burke, None; Michael Altaweel, None; P. Kumar Rao, None; Janet Holbrook, None; Susan Elner, None; Richard Stawell, None; John Kempen, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5773. doi:
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      Lyndell L Lim, Francis Abreu, Elizabeth A Sugar, Alyce Burke, Michael M Altaweel, P. Kumar Rao, Janet T. Holbrook, Susan G Elner, Richard Stawell, John H Kempen, ; Prevalence and Risk Factors of Epiretinal membrane in the Multicenter Uveitis Steroid Treatment (MUST) Trial. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5773.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To report baseline prevalence and associated risk factors of epiretinal membrane (ERM) in patients with severe active non-infectious intermediate, posterior or panuveitis recruited into the Multicenter Uveitis Steroid Treatment (MUST) Trial.

Methods: All participants underwent a standardized interview, systemic examination and ophthalmic examination. Baseline OCT images were graded at the Reading Center according to the presence and severity of ERM, plus any other associated ERM complications such as macular traction. Generalized estimating equations were used to fit logistic regression models to assess risk factors while accounting for between eye correlation in patients with bilateral uveitis.

Results: Of the 479 eyes with uveitis in the MUST Trial, 435 eyes (91%) from 243 individuals had OCT images that were gradable for ERM at randomization. Time from uveitis onset > 5 years, posterior synechiae, visual acuity (VA) < 20/100, prior IOP-lowering surgery, cataract, active uveitis, and any systemic disease were associated with increased risk of inability to assess ERM with OCT.<br /> Of the 435 gradeable eyes, 126 (29%) had an ERM. In a multivariable analysis, having diabetes (OR=2.21, p=0.043), age > 50 years (OR = 2.95, p < 0.001), the presence of retinal vasculitis (OR=2.68, p=0.013), macular edema (OR=1.87, p=0.013) and uveitis activity (OR = 1.83, p = 0.050) were associated with the presence of ERM. VA worse than 20/100, cataract [including prior cataract surgery], and Vogt-Koyanagi Harada disease were associated with increased ERM prevalence; however the association was abrogated by adjustment for other risk factors in the final multivariable model.

Conclusions: Detection of ERM by OCT in patients with uveitis may be limited by the optical impact of uveitic complications such as cataract and posterior synechiae. ERM is a common complication of intermediate, posterior and panuveitis, and was associated with increasing age, diabetes, macular edema and retinal vasculitis at randomization. Additional analysis of longitudinal data is needed to estimate the incidence of ERM and determine the residual impact of ERM on VA (once uveitis activity has been treated) and its outcome over time.

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