May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Improved detection of unexpected Epiretinal Membranes (ERM) in high myopia with Scanning Laser Opthalmoscopy Heidelberg (SLO) and Optical CoherenceTomography (OCT3)
Author Affiliations & Notes
  • P. Goeminne
    Ophthalmology, Universite catholique de Lille, Lille, France
    Ophtalmologie, Clinique A Pare – Centre Nord Vision, Lille, France
  • P. Salvetti
    Ophtalmologie, Clinique A Pare – Centre Nord Vision, Lille, France
    Schepens Eye Research Institute, Harvard Medical School, Boston, MA, MA
  • L. Cardoen
    Ophthalmology, A Z Groeninge, Courtrai, Belgium
  • F. Hamon
    Ophtalmologie, Clinique A Pare – Centre Nord Vision, Lille, France
  • Footnotes
    Commercial Relationships  P. Goeminne, None; P. Salvetti, None; L. Cardoen, None; F. Hamon, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 2982. doi:
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      P. Goeminne, P. Salvetti, L. Cardoen, F. Hamon; Improved detection of unexpected Epiretinal Membranes (ERM) in high myopia with Scanning Laser Opthalmoscopy Heidelberg (SLO) and Optical CoherenceTomography (OCT3) . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2982.

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

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Abstract

Abstract: : Purpose: To improve ERM detection in high myopia with non–invasive techniques and to evaluate their surgical approach as well as visual acuity (VA) Methods: Data from 8 eyes of 6 highly myopic patients (> 6 diopters) with unexplained VA decrease, examined were analysed (5 female, 1 male, age range from 50 to 76 years of age). VA according to the ETDRS, fundus examination, SLO without injection and OCT examinations were performed both at baseline and at 2, 4, 12, and 24 weeks post op. Preoperative VA ranged from 20/200 to 20/70 and none of the patients had been diagnosed with ERMs at fundus examination. VA decrease was long standing and associated to atrophic changes or RPE anomalies related to myopia. In all cases, a three–port vitrectomy , ERM and Internal limiting membrane (ILM) removal was performed. Fluid–Air exchange was performed only in 4 cases, where a thick ERM with cysts and traction on the fovea was demonstrated on OCT. Results: All patients had indirect signs of presence of an ERM with SLO. Autofluorescence showed a small white shadow just at the foveal edge ("nail sign"). Red–Free and Infared (IR) images showed macular folds and contractions areas in all cases. OCT demonstrated the presence of macular ERMs with or without vitreoretinal tractions. In 2 cases ERM was only gently detached from the retina, and not easily detected by OCT. All patients had VA and reading capability improvement after surgery (Mean 3 lines). No retinal detachment or cataract was observed. SLO showed resolution of folds after 1 month. OCT demonstrated anatomical fovea restoration between one and three months after surgery depending of preoperative tractions . Conclusions: This study seems to show necessity of ERM detection if high myopia even if VA decrease seems to be related to atrophic areas. SLO Heidelberg and OCT seem to be complementary in detecting ERMs and in leading patients to surgery. Functional improvement can be achieved in these patients in spite of long standing decrease in visual function.

Keywords: macula/fovea • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • vitreoretinal surgery 
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