Abstract
Purpose:
To evaluate the prevalence of epiretinal membrane (ERM) in eyes that underwent primary repair of rhegmatogenous retinal detachment (RD) treated with scleral buckle (SB) and cryopexy when imaged with spectral domain optical coherence tomography (SD-OCT).
Methods:
62 patients were included in the study. All patients were phakic, non-diabetic and had undergone SB surgery with cryopexy at least 2 months prior to enrollment. Patients underwent complete clinical evaluation and SD-OCT macular scans were obtained using Spectralis® SD-OCT. Two scans were acquired; fast mode volume scan, with 20° OCT scan width x 20° of height, and a section scan at the level of the umbus. The scans were read by an independent observer and graded based on the presence of a hypereflective layer on the surface of the retina in any of the scans reviewed. If there was an ERM, it was further subdivided as grade 1 if it did not distort the foveal depression and grade 2 or macular pucker if altered it. Further analysis was taken regards alteration of internal segment/outer segment junction (IS/OS), presence of vitreomacular traction, macular hole and subretinal fluid in the macular area.
Results:
62 subjects were studied with a 1:1 male:female ratio and a mean age of 42.5 years-old (±13.8 years). The mean time between initial symptoms of RD and SB surgery was 29.5 days (0 to 240 days). The number of retinal breaks (holes, tears or dyalisis) responsible for RD were: 1 in 69.3% of cases and more than 2 in 30.6% of cases. In 47 patients (75.8%) the RD was caused by a retinal hole or tear, while in 15 subjects (24.2%) was caused by retinal dialysis. The time period between surgery and SD-OCT scan was 6.9 years (60 days to 26.5 years). The presence of ERM was observed in 24 patients (38%); 91.6% were grade 1 and 8.3% were macular puckers. Alteration in the IS/OS was observed in 14 eyes (22.5%). A macular lamellar hole was present in 3 eyes; 3 eyes exhibited vitreomacular traction syndrome; while in 6 eyes subretinal fluid was recognized.
Conclusions:
SD-OCT enable us to objectively measure the prevalence of ERM in patients that had undergone SB surgery with cryopexy for primary repair of RD. We found an ERM prevalence of 38%. To the best of our knowledge, this is the first study that analyzes ERM prevalence based on objective data gather though SD-OCT technology.
Keywords: 697 retinal detachment •
552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) •
463 clinical (human) or epidemiologic studies: prevalence/incidence