Abstract
Abstract: :
Purpose: To evaluate the correlation between Optical Coherence Tomography ( OCT) and Ultrasound (US) pathological findings in patients with Epiretinal Membrane (E.M.). Methods: 145 consecutive patients ( 290 eyes), with biomicroscopy suspect of E.M., underwent OCT for morphology study of the retina and US to study the vitreous aspects. Every patient was assigned to a specific risk group according to the following pathology: diabetes, myopia, uveitis, after trauma, after laser, after surgery, idiopathic. By OCT, E.M. morphology was classified as : simple, associated to macular edema , associated to macular hole. By US, vitreous was classified as: normal, partial vitreous detachment (PVD), total vitreous detachment(TVD), partial vitreous detachment with vitreous traction(PVDTR) and vitreous disorganization. We use the K statistic to evaluate the concordance between biomicroscopy and OCT in the diagnosis of E.M. Chi square test was used to compare classes of E.M. and vitreous among different pathologies and to study the association between vitreous and OCT. In order to assess the association of E.M. classes and vitreous classes with symptoms , logistic regression analysis was performed. The association of E.M. classes and vitreous with visual acuity was studied by two ways ANOVA. Results: There was no concordance between biomicroscopic examination and OCT (K: .0.051) in the E.M. classes. E.M. simple was more frequent in diabetes, in myopia, in idiopathic classes (53%; 42%; 54%); E.M. with oedema was more frequent in after laser and after surgery classes ( 51%; 47%). In trauma 50% presented E.M. with macular hole, 50% E.M. simple. In uveitis 50 % presented E.M. simple, 50% E.M. with oedema. There was a significant association between OCT and vitreous (p=0.001). PVDTR was for the 63% associated to E.M. with oedema. TVD was for 43% associated with E.M. simple. PVD was for the 36% associated to E.M. simple. All these types of vitreous were uniformly associated with E.M. and macular hole. In almost every class TVD was the most frequent. In the trauma class the 50% presented TVD, 50% PVDTR. E.M. with oedema was independently associated with symptoms (p=0.001). No correlation was found between OCT, US and VA. Conclusions: OCT help to differentiate E.M. classes better than biomicroscopy. The linked study of OCT and ultrasound may help to better know the relationship between retina and vitreous in E.M.
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, S • retina • vitreous