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      Epiretinal membrane profile on spectral domain optical coherence tomography in patients with uveitis

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          Abstract

          Purpose:

          To study the epiretinal membrane (ERM) profile on the spectral-domain optical coherence tomography (SDOCT) in eyes with uveitis.

          Methods:

          In this prospective observational study, macula of uveitic eyes were evaluated by SDOCT (Cirrus, model 5000) for ERM. ERM was quantified (in microns) and were followed up along with the best-corrected visual acuity (BCVA) and treatment profile for 1 year. ERM morphology (focal, global, or mixed) and characteristics (thickness at fovea, maximum thickness, and location of maximum thickness in relation to fovea) were documented. Changes in altered foveal contour, cystoid macular edema (CME), and central foveal thickness were also noted. BCVA was noted when the inflammation subsided and it was correlated to specific ERM characteristics. SDOCT characteristics were compared in three treatment groups (no oral steroids, oral steroids with, and without immunomodulators).

          Results:

          Thirty-four eyes of 25 patients were evaluated. Mean logMAR BCVA decreased from 0.25 to 0.35 ( P = 0.005). Foveal involvement with ERM ( P = 0.011), lost foveal contour ( P = 0.043), and ellipsoid layer disruption ( P = 0.017) were associated significantly with reduced BCVA. Focal attachment of ERM was more commonly associated with CME ( P = 0.03). Median ERM thickness showed significant increase ( P < 0.001). Significant ERM progression from parafoveal to foveal ( P = 0.02), significant progression of the thickest area of ERM closer to fovea ( P = 0.0006) indicated a strong tendency of foveal involvement and this was correlated with worse BCVA ( P = 0.009, r = −0.44) Oral steroids/immunomodulators showed no significant benefit on ERM progression.

          Conclusion:

          ERM progression in uveitis has a tendency to involve the fovea and is associated with significant vision loss, particularly in foveal ERM, focal attachment, and IS-OS disruption. Oral steroids and immunomodulators have no role in halting progression.

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          Most cited references21

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          The epidemiology of vitreoretinal interface abnormalities as detected by spectral-domain optical coherence tomography: the beaver dam eye study.

          To describe the prevalence and interrelationships of epiretinal membranes (ERMs), vitreomacular traction (VMT), macular cysts, paravascular cysts (PVCs), lamellar macular holes (LMHs), full-thickness macular holes (FTMHs), and visual impairment in a population-based study of older adults.
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            • Article: not found

            Associations between macular findings by optical coherence tomography and visual outcomes after epiretinal membrane removal.

            To identify characteristics measured by optical coherence tomography (OCT) that are correlated with visual outcome after epiretinal membrane (ERM) removal by pars plana vitrectomy (PPV). Interventional, prospective, randomized case series. One hundred and one eyes of 101 patients with idiopathic ERM underwent PPV for ERM removal. Ophthalmic evaluations included best-corrected visual acuity (BCVA) and Stratus OCT preoperatively at 3 and 6 months postoperatively. Relations between three OCT features including integrity of junction between inner and outer segments of photoreceptors (IS/OS junction), macular thickness, foveal contour and the three visual acuity parameters such as preoperative BCVAs, postoperative BCVAs, and the differences between preoperative and postoperative BCVAs (BCVA differences) were evaluated with respect to time. Eyes with disruption of IS/OS junction had significantly lower postoperative BCVA and BCVA differences than those without disruption (P 0.25; P .05, respectively). Photoreceptor disruption detected by OCT was found to be a predictor of poor visual outcome in eyes with idiopathic ERM, and it was found that this disruption may be irreversible. Thus, early membrane removals may beneficially prevent further progression of photoreceptor damage in ERM patients with photoreceptor disruption.
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              • Record: found
              • Abstract: found
              • Article: not found

              Spectral-domain optical coherence tomography for monitoring epiretinal membrane surgery.

              To assess prognostic factors in epiretinal membrane (ERM) surgery using spectral-domain (SD) optical coherence tomography (OCT).
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                Author and article information

                Journal
                Indian J Ophthalmol
                Indian J Ophthalmol
                IJO
                Indian Journal of Ophthalmology
                Medknow Publications & Media Pvt Ltd (India )
                0301-4738
                1998-3689
                March 2019
                : 67
                : 3
                : 376-381
                Affiliations
                [1]Department of Uvea and Oncology Services, Dr Agarwal's Eye Hospital, 19 Cathedral Road, Chennai, Tamil Nadu, India
                Author notes
                Correspondence to: Dr. Dhivya Ashok Kumar, Department of Uvea and Oculoplasty Services, Dr Agarwal's Eye Hospital, 19 Cathedral Road, Chennai - 600 086, Tamil Nadu, India. E-mail: susruta2002@ 123456gmail.com
                Article
                IJO-67-376
                10.4103/ijo.IJO_650_18
                6407406
                30777956
                39917218-f918-4d65-9963-05b726eaca2b
                Copyright: © 2019 Indian Journal of Ophthalmology

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 21 April 2018
                : 24 October 2018
                Categories
                Original Article

                Ophthalmology & Optometry
                epiretinal membrane,epiretinal membrane changes in spectral domain oct,optical coherence tomography,uveitis

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