Abstract
Purpose :
To determine the frequency of microcystic macular edema (MME) in patients with epiretinal membranes (ERM) and to explore its association with glaucoma.
Methods :
We retrospectively included eyes with ERMs and reviewed their baseline clinical characteristics including the presence of glaucoma. Optical coherence tomography (OCT) images were reviewed for the presence of MME as evidenced by hyporeflective cystic spaces within the inner nuclear layer (INL). Quantitative analysis of MME was performed by manually counting the number of INL cysts within a volume (20° x 15°) OCT scan. Mean number of INL cysts were compared between eyes with glaucoma and those without. In addition, eyes that underwent vitrectomy for ERM removal were divided based on the presence of glaucoma. The number of INL cysts between the two groups at baseline and 6 months after surgery were analyzed and compared. Mean visual acuities between the two groups were compared at baseline and 6 months after surgery.
Results :
Two hundred and sixty-eight eyes with ERMs were included (53 with glaucoma and 215 without). MME was present in 27 eyes with glaucoma (50.9%) and 19 eyes without glaucoma (8.8%, p<0.0001). Thirty-eight eyes (19 with glaucoma and 19 without glaucoma) underwent vitrectomy for ERM removal. At baseline, the mean number of INL cysts between the glaucoma and non-glaucoma groups were not significantly different (49.9 ± 65 and 83 ± 99, respectively; p = 0.33). Mean visual acuity of the glaucoma and non-glaucoma groups were similar at baseline (logMar 0.39 ± 0.15 and 0.40 ± 0.16, respectively; p = 0.9). Six months after ERM removal, the number of INL cysts decreased in 10/19 eyes (52.6%) with glaucoma and in 17/19 eyes (89.4%) without glaucoma. The number of INL cysts increased in 9/19 eyes (47.3%) with glaucoma (Fig. A) and in only 2/19 eyes (10.5%) without glaucoma (p=0.02; Fig. B). Mean visual acuity was significantly improved at 6 months post-operatively in the non-glaucoma group (logMar 0.30 ± 0.20; p=0.003) but not in the glaucoma group (0.32 ± 0.25; p=0.2).
Conclusions :
MME was more likely to be present in eyes with ERMs and glaucoma than those with ERMs but without glaucoma. Furthermore, MME was more likely to persist or worsen after vitrectomy for ERM removal in eyes with glaucoma.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.