Abstract
Purpose :
Uveitis patients are prone to developing epiretinal membranes (ERM), which are fibrous layers that form on the inner retina and may cause severe macular and visual dysfunction. ERMs are usually left to observation or removed via surgery, but there is little research on the outcomes and post-operative management of ERM peel for uveitis patients. This study aims to compare ERM outcomes and clinical characteristics between uveitis patients who do or do not undergo surgery.
Methods :
We conducted a retrospective cohort study of adult uveitis patients who received treatment for ERM at Johns Hopkins in 2013-2023. Out of 246 patients who received ERM peel, we examined 43 patients who received surgery between 2020 and 2022 and followed up to 1-year post-operation. The results were compared to 43 randomly selected non-surgery patients and analyzed across the same period. Fisher’s exact test, t-test, and Wilcoxon rank sum tests were used to compare demographics, comorbid conditions, visual acuity, medications, and more.
Results :
Patients who received surgery had lower median age at ERM diagnosis than those who did not (59 vs 65 yrs, p = 0.028). Surgery patients also were significantly more likely to have or develop cystoid macular edema (CME, 44.19% vs 16.28%, p = 0.027). The cohorts were similar in demographics and other comorbidities such as macular degeneration and glaucoma. The mean change in logMAR visual acuity in the operative or ERM-affected eye over the study period was significantly more negative in surgery patients (-0.4879 vs -0.0793, p=0.016). The mean logMAR change was significantly different from zero in the surgery group but not in the other (p = 0.001, p = 0.367 respectively). Surgery patients had higher mean intraocular pressure (14.15 vs 12.49, p=0.014) and higher rates of cataract removal during the study period (35.56% vs 5.71%, p=0.001). They also had significantly higher use of steroid drops (93.33% vs 48.57%, p=7.16e-6) and NSAID drops (55.56% vs 2.86%, p=1.63e-7) compared to patients who did not receive ERM surgery, but they had similar usage of oral steroids and immunosuppressive agents.
Conclusions :
Patients who received ERM peel saw significant improvement in visual acuity over 1 year, unlike patients who did not receive surgery. However, surgery patients also had higher rates of cataract removal and CME.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.