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DEBARSHI MUSTAFI, Brian K Do, Narsing A Rao; Relationship of Epiretinal Membrane Formation and Macular Edema Development in Uveitic Eyes. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6678. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Macular edema (ME) is recognized as the most common cause of visual impairment in uveitic patients. The association of epiretinal membrane (ERM) formation with uveitis and uveitic ME is being recognized as a more common occurrence contributing to visual decline. Large population based studies are necessary to understand the impact and incidence of both of these entities in uveitic patients to better guide our diagnostic and therapeutic approaches.
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 December 2017 was conducted. A total of 269 patients comprising 444 uveitic eyes met the study inclusion criteria. The presence or absence of ME and ERM was confirmed with spectral domain optical coherence tomography (SD OCT). All patients underwent a comprehensive ophthalmic examination to classify the primary anatomic site of inflammation. Specific etiological diagnosis of uveitis was established by the clinical picture and appropriate tailored testing approaches.
Anterior uveitis, despite being the most common subtype of uveitis classified by anatomic site (44.1%), only accounted for 9.7% of all uveitic ME cases. Panuveitis was the most frequent anatomical subtype associated with uveitic ME, comprising 50.8% of all cases. ERM formation was noted to be significantly higher in intermediate, posterior and panuveitis all exhibiting greater than 60% ERM formation, whereas those with anterior uveitis exhibited ERM formation in only 37% of eyes being affected (p<0.05). The majority of ME and ERM was noted in non-infectious etiologies and particular clinical entities. Furthermore, 97.7% of eyes with uveitic ME were found to also have ERMs, and in the vast majority (94.1%) the ERM was noted concurrently or prior to ME development.
This study determined that there is an increased prevalence of ERM formation in uveitis patients while also demonstrating that ME resulting from uveitis is highly correlated with ERM formation. Moreover, etiological analysis of this patient population highlighted those that are more prone to ME and ERM related complications. This study is the first to elucidate the temporal relationship of uveitic ME and ERM and highlights the importance of structural characterization of ERM as it relates to the development of uveitic ME.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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