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M.M. Zorn, G.I. Kaucher, G.K. Lang, G.E. Lang; Evaluation of Epiretinal Macular Membranes by Optical Coherence Tomography . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4022.
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© ARVO (1962-2015); The Authors (2016-present)
To identify the characteristics of primary and secondary epiretinal macular membranes (ERM) by optical coherence tomographic (OCT) parameters and to compare them with clinical and fluorescein angiographic (FAG) findings.
79 consecutive patients with primary and secondary ERMs were prospectively examined over a five month period using a standardized protocol. The protocol included best corrected visual acuity (BCVA), slit–lamp biomicroscopy, OCT examination, fundus photography and fluorescein angiography (FAG). In a masked fashion the OCT findings of ERMs were independently graded according to 10 different parameters and then statistically analysed by confidence interval charts for associations with two clinically graded subgroups, stage I (St I=cellophane maculopathy) and stage II (St II= macular pucker).
110 eyes of 79 patients, age ranging from 29 to 87 (median 69 years) were included in the study. 91 patients presented with ERM stage I, 19 with stage II, 27 patients with primary and 83 with secondary ERMs. BCVA ranged from 0.05 to 1.0 (median 0.4). OCT findings: Foveal minimum was 132 to 1063 microns (median 245); 64 patients had a normal OCT or a discreet hyperreflectivity of the internal retinal surface, 14 a hyperreflective band, 31 focal adhesions, 62 loss of foveal depression, 47 cystoid macular edema, 15 vitreomacular traction, 5 detachment of the ERM, 7 pseudohole, 4 macular hole, 15 vitreous detachment. A normal OCT or a discreet hyperreflectivity of the internal retinal surface (p=0.01) was a statistically significant OCT parameter that correlated with stage I; focal adhesion (p=0.05) and vitreomacular traction (p=0.01) were statistically significant OCT parameters that correlated to stage II. Fluorescein leakage and cystoid macular edema were statistically significant (p=0.01) FAG parameters that correlated to secondary ERMs. Cystoid macular edema, loss of foveal depression are most likely associated with seconadary ERMs. Pseudoholes are most likely associated with primary ERMs.
The OCT findings contribute to the proper diagnosis of ERM and give additional helpful information concerning treatment and follow–up examination.
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