In 133/1303 (10.2%) of patients from our cohort, MME was present according to the refined diagnostic criteria (
Table 1). There was a slight female predominance (57.1%) in the MME group. Patients with MME were significantly older (72.8 years, SD 13.8, range, 23–95 years) compared with patients without MME (63.2 years, SD 17.8, range, 4–101 years;
P = 0.002), and healthy control subjects (50.5 years, SD 7.2, range, 28–63 years;
P < 0.001). The clinical spectrum and demographic data of patients with MME is summarized in
Table 2. Most frequently, MME was observed in patients with ARMD (27.1%) followed by patients with preceding ophthalmic surgery (20.3%) or presence of an epiretinal membrane (18.8%). Furthermore, MME was identified following a retinal vascular occlusion (6.8%), uveitis (6.8%), diabetic retinopathy (6.8%), MS (3.0%), posterior ischemic optic neuropathy (0.8%), and miscellaneous/other retinal conditions (5.3%). Three of the four patients with MS had a history of optic neuritis in the affected eye. Importantly, the patient who never suffered from optic neuritis had a long disease duration (14 years), was severely disabled (EDSS 6.0), showed severe white and gray matter atrophy involving the optic pathways on magnetic resonance imaging (MRI), and had bilaterally delayed visual evoked potentials (this patient never received fingolimod).
Figure 3 shows an example of a normal retina of a healthy control subject compared with the retina of a patient with MME based on ARMD. Other examples of OCT images of patients found in the different disease categories are presented in
Figure 4.
Figure 5 shows an example of a patient presenting both with an optic neuritis and a branch retinal vein occlusion at the same time (MME was seen 11 years after onset).