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N.O. Martinet, N. Cassoux, B. Bodaghi, T. Tran, P. Le Hoang; Visual Outcome After Uveitis–Related Epiretinal Membrane Surgery . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4678.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate postoperative visual outcome of uveitis–related epiretinal membrane.
Retrospective, interventional, noncomparative case series of 19 patients (20 eyes) with epiretinal membrane (ERM) and uveitis, who underwent standard three port pars plana vitrectomy and membrane stripping, with a 22–month follow–up. Surgery was proposed when intraocular inflammation was controlled by specific treatment and corticosteroids (triamcinolone and/or prednisolone). Preoperative and postoperative functional results were assessed with best–corrected visual acuity (BCVA) on logMAR scale. Macular morphology was assessed with stereoscopic biomicroscopy, fluorescein angiography and optical coherence tomography.
19 patients (9 men, 10 women) with uveitis, mean age 44.3 years, were evaluated. Uveitis was bilateral in 57.9% of cases, and unilateral in 42.10% of cases. Inflammation was posterior (21 eyes), intermediate (4 eyes) and total (5 eyes). ERM occurred in 66.6% of cases and was bilateral in 13.3% of cases. It was successfully removed in all cases. Two groups were identified:
–First group with poor visual outcome: 11 patients, mean age 41.8 years. Mean BCVA decreased from 0.79 logMAR preoperatively to 0.85 logMAR postoperatively (p<0.05). Preoperative cystoid macular edema (CME) was present in 83.3% of cases with mean duration of 22.7 months (p>0.05). It postoperatively persisted in 83.3% of cases. ERM was at the posterior pole in 50% of cases with vitreomacular traction in 83.3%. Macular traction was present in 50% of cases. Mean complications consisted in ERM recurrence, lamellar hole, retinal detachment, glaucoma, and chronic CME.
–Second group with good visual outcome: 8 patients, mean age 47.8 years. Mean BCVA improved from 0.65 logMAR to 0.18 logMAR postoperatively (p<0.05). Preoperative CME existed in 75% of cases, during 14 months (p>0.05) and persisted postoperatively in 37.5% of cases. In 75% of cases, ERM was at the posterior pole without vitreomacular traction. Uveitis was associated with sarcoidosis, immune recovery uveitis, toxoplasmosis and Behçet disease.
Unlike idiopathic type, uveitis–associated ERM occurs at earlier age and preoperative CME seems not to be a significant prognostic factor. Surgery appears to have a beneficial effect on restoring vision when preoperative BCVA is not significantly altered and when ERM is localized at the posterior pole without vitreomacular tractions.
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