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Debarshi Mustafi, Brian Do, Narsing A Rao; Effect of combined presence of epiretinal membrane and cystoid macular edema on visual acuity in uveitis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4211.
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© ARVO (1962-2015); The Authors (2016-present)
Uveitis can be complicated by cystoid macular edema (CME) and epiretinal membrane (ERM) formation. Both can independently cause loss of visual acuity, thus large population based studies examining the impact and incidence of both of these entities in uveitic patients is essential to understanding the etiology of visual decline. This work reports the anatomical pattern and associated complications with uveitis from a large tertiary care center.
A retrospective review of patients with uveitis examined at the Department of Ophthalmology at the University of Southern California Roski Eye Institute from August 2015 to September 2017 was conducted. Data from 237 patients consisting of 405 eyes was analyzed for anatomical site of inflammation, clinical diagnosis, age, sex, laterality, best-corrected Snellen visual acuity, as well as presence or absence of cystoid macular edema and epiretinal membrane using spectral domain optical coherence tomography (SD OCT).
In the population reviewed, the most prevalent anatomical inflammatory site was anterior (46%), followed by posterior (34%), panuveitis (13%), and intermediate (6%). The overall incidence of CME was 24% whereas ERM formation was 60%. Patients with panuveitis and posterior uveitis had the highest incidence of CME as well as ERM. The incidence of both CME and ERM together was 88% across all patients, with correlation of the two findings as high as 94% in patients with panuveitis. These findings were statistically significant when compared with the incidence of either complication independently (p-value <0.001). Furthermore, the mean Snellen visual acuity was noted to be worse in patients with both CME and ERM compared to the occurrence of either independent complication (p-value <0.05). In patients with anterior uveitis, only 12% of all patients were noted to have CME on SD OCT, whereas 77% of those with CME also had ERM that also correlated with the laterality of inflammation.
In this study there was a high correlation between ERM formation and CME in uveitis patients. Moreover, the combination of these two entities demonstrated a detrimental effect on visual acuity outcome. This study elucidates the correlation of these two uveitic complications, its impact on visual acuity outcome, and the need for more careful follow-up in these patient populations.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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