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Nicole De Cuir, Juliet Idiga, Khushmit Kaur, Jeffrey Odel, Gustavo V De Moraes, Robert Ritch, Donald C Hood; Prevalence and Characterization of Epiretinal Membranes in Patients with Optic Nerve Disease. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6216.
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Because patients with optic nerve disease can exhibit ocular inflammation and it has been hypothesized that inflammation can lead to ERM formation, we compared the prevalence and characteristics of epiretinal membranes (ERM) in glaucoma patients, glaucoma suspects, patients with other optic nerve diseases, and healthy controls.
fdOCT horizontal cube scans of the macula (Topcon Inc, Japan) were obtained and examined for the presence of ERMs, which were classified as: Simple [a thickened, hyper-pigmented region of the inner limiting membrane (ILM)-see Fig. 1a] or Complex (i.e. a thickened region of the ILM that has a gap separating it from retinal nerve fiber layer, which in some cases appeared distorted-see Fig. 1b). The study population included 54 eyes of 54 control patients (52.8 ± 8.2 yrs), 75 eyes of 75 glaucoma patients (58.1 ± 11.5 yrs), 49 eyes of 49 glaucoma suspects (51.2 ± 13.4 yrs), and 56 eyes of 56 patients with other optic nerve diseases (47.32± 17.6 yrs). Glaucoma patients and suspects had glaucomatous optic neuropathy, with abnormal (glaucoma) or normal (suspects) 24-2 visual fields based upon cluster criteria. The patients with other optic nerve disease included patients with MS, ischemic optic neuropathy, and optic atrophy.
Overall, 83.3% of control eyes, 60.0% of glaucomatous eyes (GL), 67.4% of glaucoma suspect eyes (GS), and 82.2% of eyes with other optic nerve disease (OND) exhibited ERMs (Table). Based upon age-adjusted logistical regression, the prevalence of ERMs in the patient groups was not significantly greater than the controls [Odds Ratio: 0.34 (G); 0.41 (GS), 0.83 (OND)]. Of note, 30 (16.7%) of the patients’ eyes, but none of the control eyes, had complex ERMs. However, only age was a statistically significant predictor of complex ERMs. Given that the control group was significantly younger than the patient groups, we cannot rule out the possibility that patients are more likely to develop complex ERMs with age.
The patients with optic nerve disease did not show an increased prevalence of ERMs. Complex ERMs are more likely with age and it is possible that this is even more so in patients. Older controls need to be added to test this hypothesis.
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