Clinical Ophthalmology (Dec 2019)

The Clinical Course of Patients with Idiopathic Epiretinal Membranes and Good Visual Acuity Managed Without Surgery

  • Damasceno EF,
  • Damasceno NA,
  • Crane AM,
  • Yannuzzi NA,
  • Relhan N,
  • Smiddy WE,
  • Flynn HW

Journal volume & issue
Vol. Volume 13
pp. 2469 – 2475

Abstract

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Eduardo F Damasceno,1,2 Nadyr A Damasceno,1,3 Ashley M Crane,1 Nicolas A Yannuzzi,1 Nidhi Relhan,1 William E Smiddy,1 Harry W Flynn1 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, FL, USA; 2Department of Ophthalmology, Universidade Federal Fluminense, Niteroi, RJ, Brazil; 3Department of Ophthalmology, Hospital Naval Marcilio Dias, Rio de Janeiro, RJ, BrazilCorrespondence: Harry W FlynnDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 900 N.W. 17th Street, Miami, Florida 33136, USATel +1-305-326-6118Fax +1-305-326-6417Email [email protected]/aims: To report the clinical course of patients with idiopathic epiretinal membranes (iERMs) and good baseline best-corrected visual acuity (BCVA) managed without surgical treatment.Methods: Retrospective, observational case series of patients with iERMs and 20/50 or better BCVA who did not undergo surgery between January 2014 and December 2017 with a 1-year follow-up. Secondary epiretinal membranes were excluded. iERMs were stratified into two groups: Group I (BCVA 20/30 or better) and Group II (BCVA 20/40 to 20/50). The main outcome measures included baseline and final follow-up BCVA, central macular thickness (CMT) on OCT.Results: The study included 174 eyes (145 patients): 139 eyes (79.8%) had typical iERMs and 35 eyes (18%) had LMH. For Group I typical iERMs, the logMAR baseline and final mean BCVA were 0.09 ± 0.1 (Snellen equivalent 20/25) and 0.10 ± 0.1 (20/25+) respectively (p = 0.22). In this group, the baseline and final mean CMT were 335 ± 73μm and 342 ± 78μm, respectively (p = 0.47). For Group II typical iERMs, the logMAR baseline and final mean BCVA were 0.3 ± 0.1 (20/44) and 0.4 ± 0.2 (20/45) respectively (p = 0.31). In this group, the baseline and final mean CMT were 386 ± 95μm and 391 ± 93μm, respectively (p = 0.84).Conclusion: The clinical course of patients with iERM and good baseline BCVA is generally favorable without surgery and includes stable BCVA and OCT measurements after at least one year.Keywords: epiretinal membrane, pars plana vitrectomy, optical coherence tomography

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