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Ravivarn Jarukasetphon, Lynn Shi, Robert Fargione, Zane Zenon Zemborain, Luis Silva, Carlos Gustavo De Moraes, Robert Ritch, Donald Hood; Prevalence and risk factors for epiretinal membrane (ERM) in glaucomatous eyes with and without exfoliation syndrome. Invest. Ophthalmol. Vis. Sci. 2017;58(8):692.
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© ARVO (1962-2015); The Authors (2016-present)
To determine whether eyes with exfoliation glaucoma (XFG) have higher prevalence of ERM than glaucoma eyes without exfoliation and to evaluate the risk factors for ERM.
70 eyes (age: 72.4±7.6 yrs, 24-2 mean deviation (MD): -7.03±7.47dB) of 46 XFG patients, 115 eyes (age: 72.05±4.90 yrs, MD: -7.78±6.47 dB) of 64 POAG patients, 120 eyes (age: 52.8±14.3 yrs, MD: -1.52±2.05 dB) of 66 glaucoma suspects (GS) by optic nerve appearance, and 137 eyes (age: 56.1±14.8 yrs, MD: -1.16±1.91 dB) of 77 OHT patients were evaluated for the presence of complex ERM. A complex ERM involved a distortion of the retinal nerve fiber layer (e.g. Figs. 1 and 2). ERM were identified on widefield scans (9x12 mm, 512x256 B-scans) obtained with swept-source OCT (DRI OCT, Topcon inc.) or macular cube scan (6x6 mm, 512x128 B-scans) obtained with spectral domain OCT (3D OCT 2000, Topcon inc.). Eyes with a history of retinal detachment were excluded. Age, IOP, refractive error, history of cataract surgery, previous trabeculectomy, and severity of glaucoma on visual field assessment were considered as possible contributing factors.
XFG had the greatest prevalence of ERM (28.6%), followed by POAG (16.5%), GS (5%), and OHT (4.4%). However, the difference between eyes with XFG and POAG (P=0.09) was not significant. The prevalence of ERM in GS was about the same as OHTN (P=0.84). Older age and history of cataract surgery were significantly associated with ERM (P=0.007 and P=0.004, respectively). Presence of glaucoma or exfoliation, severity of glaucoma and myopia did not significantly impact the prevalence of ERM. Eyes with XFG/POAG had more ERMs than GS/OHTN eyes (P<0.001). However, after adjusting for confounders, the difference was not significant.
Prevalence of ERM is highest in XFG eyes. Older age and history of cataract surgery are predisposing factors for ERM. It is important to screen for ERM in XFG eyes.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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