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Fanny Ricouard, Pauline Foveau, Anne Zimmermann, Jean Baptiste Conart, David Gaucher, Maher Saleh; Prevalence and incidence of epimacular membranes in patients with wet AMD. Invest. Ophthalmol. Vis. Sci. 2016;57(12):50.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study was to report the prevalence of epimacular membranes (ERM) in a population followed for age-related macular degeneration (AMD) and to assess their incidence of onset over time.
Multicentric study of the EAST group (Eastern French Studies and Trial Group) (3 sites: Besancon, Nancy, Strasbourg) from the Vitreo-macular interface in the Age-related macular degeneration study (EVA study). All patients had consecutive control visits with Spectral-Domain OCT (Spectralis, Heidelberg Engineering, Heidelberg, Germany). The OCT protocol consisted of the acquisition of horizontal cross-sectional scans passing through the fovea and 3 and 6 mm of either side. The vitreomacular interface has been described according with the IVTS nomenclature.
195 patients with one or both eyes treated for wet AMD (266 eyes) were studied. The average age was 79 years (55-96y; med 81). The mean follow-up was 32.7 months (2.9-77; med 29.3), with an average number of intravitreal injections (IVI) of anti angiogenic factors (bevacizumab, ranibizumab,aflibercept) and/or corticosteroids (dexamethasone) of 12.1 (0-60; med 9). 23.3 % of eyes treated displayed a ERM at baseline and 24.1% at the end of follow-up. 22.4% of predominantly classic choroidal neovascularization (NVC) AMD showed ERM, 20.9 % of minimally classic NVC, 23.6% of occult NVC, 33.3% of polypoidal choroidal vasculopathy, 13.3% of chorioretinal anastomoses (RAP) and 37.9% of AMD at the stage of fibrosis scar.During follow-up, 3.0 % of eyes treated have developed ERM. Final visual acuity (VA) was significantly lower in patients with ERM (p<0.01) with an average of 40.1 ETDRS letters against 53.6 in patients without ERM. The average number of IVI in patients with ERM was not significantly higher (p> 0.05). 9.6% patients with ERM underwent vitreoretinal surgery, with an average gain of 5.4 ± 5.7 letters.
Epiretinal membranes are frequent in patients treated for wet AMD and are associated with a lower VA. Nevertheless, they do not imply a higher need of injections. A study to assess the benefit of ERM surgery in patients with AMD is currently conducted.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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