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Xuejing Chen, Chirag Shah, Jeffrey Heier; Progression to Surgery for Epiretinal Membranes with Good Vision. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4254.
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© ARVO (1962-2015); The Authors (2016-present)
Idiopathic epiretinal membranes (ERM) with visual acuity better than 20/40 are often monitored until the vision worsens or the associated symptoms warrant surgical intervention. This study looks at the rate of progression to surgery as well as the characteristics associated with progression.
This is a retrospective, consecutive case series of all patients with newly diagnosed idiopathic ERMs referred to the Retina Service of Ophthalmic Consultants of Boston between 2009 and 2011. Included eyes had 20/40 or better visual acuity (VA). Eyes with secondary ERMs (eg, from retinal detachment, vascular occlusions, uveitis) were excluded. Surgical membrane peeling was typically offered when vision worsened to 20/50 or beyond and/or when patients were not able to tolerate symptoms attributable to the ERM. Outcome measures include rate of progression to surgical intervention. Characteristics associated with progression will be discussed.
A total of 72 eyes from 60 patients were identified. Average age was 68 ± 6.3 years old. Average presenting Snellen VA was 20/29 (range 20/20 to 20/40). Average follow up duration was 3.72 ± 1.83 years (range 1.02 to 7.03 years). On presentation, 36 eyes were asymptomatic; and metamorphopsia was present in 16 eyes, generalized blurry vision in 13 eyes, and other symptoms in 7 eyes. Seventeen patients were pseudophakic. The Kaplan Meier survival curve for progression to surgical intervention for all eyes at 6.5 years was 22%. VA at time of surgery averaged 20/75.
Patients with ERMs that are not considered initial candidates for surgical intervention often inquire about their risk of progression. This study shows progression to surgical membrane peeling at 6.5 years is 22%. Further research is needed to weigh the rate of progression against any irreparable vision loss that may occur from long-standing ERMs.
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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