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Mark Krakauer, Clement Chow, William F. Mieler, Jennifer I. Lim; Scrolled Epiretinal Membrane: Case Series Of A Novel OCT Finding. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1173.
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To describe the clinical appearance and spectral domain optical coherence tomography (SD-OCT) findings of a series of patients with a novel vitreoretinal interface abnormality.
We performed a retrospective, observational case study of 14 patients with hyperreflective vitreoretinal interface abnormalities in a scrolled configuration found on Heidelberg SD-OCT imaging. Demographic information, clinical characteristics and SD-OCT ultrastructural features were recorded.
Fourteen eyes of 14 patients were identified. The mean age was 60 years (range 28-77, median 65). Eight patients (57%) were male. Visual acuities were 20/40 or better in 7 eyes (50%), 20/50 to 20/200 in 6 eyes (43%), and worse than 20/200 in 1 eye (7%). Four patients (29%) were visually asymptomatic, while ten (71%) reported blurred vision or metamorphopsias. The vitreoretinal interface abnormalities were located above the fovea or parafoveal in eight (57%) and perifoveal in six eyes (43%). The mean SD-OCT central subfield thickness was 441 microns (range 249-1059, median 402). Three patients underwent pars plana vitrectomy and retinal membrane peeling. No intraoperative difficulties were encountered. Post-operatively, visual acuity and central subfield thickness improved, and the hyper-reflective material resolved. For the patients without surgical intervention and for whom follow-up SD-OCT was available, visual acuity improved or remained stable and the hyperreflective vitreoretinal interface abnormalities appeared unchanged.
Focal contraction of the internal limiting membrane and epiretinal membrane can result in hyperreflective vitreoretinal interface abnormalities and may have a scrolled "egg-like" appearance on SD-OCT. Visual acuity is usually minimally affected in these conditions.
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