May 2006
Volume 47, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2006
Visual Outcome After Uveitis–Related Epiretinal Membrane Surgery
Author Affiliations & Notes
  • N.O. Martinet
    Ophthalmology, Pitié – Salpétrière Hospital, PARIS, France
  • N. Cassoux
    Ophthalmology, Pitié – Salpétrière Hospital, PARIS, France
  • B. Bodaghi
    Ophthalmology, Pitié – Salpétrière Hospital, PARIS, France
  • T. Tran
    Ophthalmology, Pitié – Salpétrière Hospital, PARIS, France
  • P. Le Hoang
    Ophthalmology, Pitié – Salpétrière Hospital, PARIS, France
  • Footnotes
    Commercial Relationships  N.O. Martinet, None; N. Cassoux, None; B. Bodaghi, None; T. Tran, None; P. Le Hoang, None.
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science May 2006, Vol.47, 4678. doi:
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      N.O. Martinet, N. Cassoux, B. Bodaghi, T. Tran, P. Le Hoang; Visual Outcome After Uveitis–Related Epiretinal Membrane Surgery . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4678.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate postoperative visual outcome of uveitis–related epiretinal membrane.

Methods: : Retrospective, interventional, noncomparative case series of 19 patients (20 eyes) with epiretinal membrane (ERM) and uveitis, who underwent standard three port pars plana vitrectomy and membrane stripping, with a 22–month follow–up. Surgery was proposed when intraocular inflammation was controlled by specific treatment and corticosteroids (triamcinolone and/or prednisolone). Preoperative and postoperative functional results were assessed with best–corrected visual acuity (BCVA) on logMAR scale. Macular morphology was assessed with stereoscopic biomicroscopy, fluorescein angiography and optical coherence tomography.

Results: : 19 patients (9 men, 10 women) with uveitis, mean age 44.3 years, were evaluated. Uveitis was bilateral in 57.9% of cases, and unilateral in 42.10% of cases. Inflammation was posterior (21 eyes), intermediate (4 eyes) and total (5 eyes). ERM occurred in 66.6% of cases and was bilateral in 13.3% of cases. It was successfully removed in all cases. Two groups were identified: –First group with poor visual outcome: 11 patients, mean age 41.8 years. Mean BCVA decreased from 0.79 logMAR preoperatively to 0.85 logMAR postoperatively (p<0.05). Preoperative cystoid macular edema (CME) was present in 83.3% of cases with mean duration of 22.7 months (p>0.05). It postoperatively persisted in 83.3% of cases. ERM was at the posterior pole in 50% of cases with vitreomacular traction in 83.3%. Macular traction was present in 50% of cases. Mean complications consisted in ERM recurrence, lamellar hole, retinal detachment, glaucoma, and chronic CME. –Second group with good visual outcome: 8 patients, mean age 47.8 years. Mean BCVA improved from 0.65 logMAR to 0.18 logMAR postoperatively (p<0.05). Preoperative CME existed in 75% of cases, during 14 months (p>0.05) and persisted postoperatively in 37.5% of cases. In 75% of cases, ERM was at the posterior pole without vitreomacular traction. Uveitis was associated with sarcoidosis, immune recovery uveitis, toxoplasmosis and Behçet disease.

Conclusions: : Unlike idiopathic type, uveitis–associated ERM occurs at earlier age and preoperative CME seems not to be a significant prognostic factor. Surgery appears to have a beneficial effect on restoring vision when preoperative BCVA is not significantly altered and when ERM is localized at the posterior pole without vitreomacular tractions.

Keywords: inflammation • vitreoretinal surgery • retina 
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