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Michael Rothschild, Joseph J Tseng, Kenneth J. Wald; Who gets surgery for idiopathic epiretinal membrane? A retrospective analysis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2795.
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No clear guidelines exist regarding when to perform vitrectomy and membrane peel surgery for idiopathic epiretinal membranes. Here we analyzed a cohort of patients diagnosed with idiopathic epiretinal membranes and compared those who desired and were offered surgery versus those who were not. Since epiretinal membranes are generally non-progressive, surgery was only offered to patients who had significant symposium and diminished acuity.
We retrospectively analyzed a consecutive series of 100 eyes from one vitreoretinal surgeon (79 patients) diagnosed with idiopathic epiretinal membranes who were referred from general ophthalmologists. For each eye we determined the best corrected visual acuity (BCVA, in LogMAR), central macular thickness (CMT) using SD-OCT (µm), age (years) and gender. Using Microsoft Excel using two-tailed t-tests we compared these parameters in patients who had and had not chosen to undergo surgery. In surgical patients, pre-op values were used. Exclusion criteria included patients with any other eye pathology that may have affected vision or macular thickness as well as surgical patients for whom we did not have pre-op data.
21 eyes underwent surgery and 79 were observed. Mean age of patients undergoing surgery was 67.7 years (SD 7.65) and 71.9 years (SD 10.10) in those who opted against surgery (p=.048). Mean pre-op visual acuity in surgical patients was 0.57 (20/75; SD 0.27) compared to 0.27 (20/40+; SD 0.22) in non-surgical patients (p=<.0001). Central macular thickness was 531.4µm (SD 81.28) in surgical patients and 370.1µm (SD 81.36) in non-surgical patients (p=<.0001).
In our retrospectively examined cohort of 100 eyes with idiopathic epiretinal membrane, patients who were offered and accepted surgical treatment were significantly younger and had worse visual acuity and more distorted anatomy (greater central macular thickness) than those patients who did not undergo surgery.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Visual acuity of patients undergoing surgery for epiretinal membrane vs. those observed
Central macular thickness of patients undergoing surgery for epiretinal membrane vs. those observed
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