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Megan Land, Yasaira Rodriguez Torres, Jonathan Hu, Asheesh Tewari; Surgical outcomes of vitrectomy for macular hole and Epiretinal Membrane in patients with coexisting advanced AMD. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2830.
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© ARVO (1962-2015); The Authors (2016-present)
To examine visual and anatomic outcomes of patients who underwent vitrectomy with membrane peeling for macular hole (MH) or epiretinal membrane (ERM).
Retrospective consecutive case series of patients of a single academic center who underwent vitrectomy for ERM or MH and had coexisting age-related macular degeneration (AMD). Patients with exudative AMD under treatment with intravitreal injection or nonexudative AMD with presence of pigment epithelial detachment (PED) or confluent soft drusen were included. Best corrected postoperative visual acuity (BCVA) and anatomic findings of macular hole closure and macular thickness were evaluated. In addition, progression of AMD as monitored by OCT findings and/or fundus autofluorescence was noted.
There were five patients who underwent vitrectomy with ERM removal and of these two had exudative AMD under treatment with intravitreal bevacizumab and three had severe nonexudative ARMD with presence of confluent soft drusen or PED. For macular hole surgery, there were two patients with coexisting PED. Patients with ERM surgery all had reduction in central macular thickness with an average reduction of 158 micrometers and visual acuity improvement from 20/168 (0.92 log Mar) to 20/82 (0.61 log Mar). In patients who underwent macular hole surgery, anatomic hole closure was found in both cases and visual acuity improved from preoperative 20/100 (0.7 log Mar) to 20/25 (0.097 log Mar) post operatively. There were no surgical complications noted in either group and no evidence of progression of exudative or nonexudative AMD at final visit.
Macular surgery for macular hole or ERM in patients with advanced ARMD resulted in overall improvement in BCVA and anatomic success and thus should be considered as a viable option in the management plan of these patients.
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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