Long-term natural history of idiopathic epiretinal membranes with good visual acuity.

ABSTRACT: BACKGROUND/OBJECTIVES:To evaluate the long-term progression of idiopathic epiretinal membranes (iERMs) with good baseline visual acuity, and to identify predictors of visual decline. DESIGN:Retrospective case series SUBJECTS METHODS: We reviewed records of 145 eyes with iERM and best-corrected visual acuity (BCVA) of 20/40 or greater at presentation, including BCVA, lens status, and central macular thickness (CMT) at yearly visits; as well as anatomic biomarkers including vitreomacular adhesion, pseudohole, lamellar hole, intraretinal cysts, disorganization of the inner retinal layers (DRIL), and disruption of outer retinal layers. Linear mixed effects and mixed-effects Cox proportional hazards models were used to identify clinical and anatomic predictors of vision change and time to surgery. RESULTS:At presentation, mean BCVA was 0.17?±?0.10 logMAR units (Snellen 20/30) and mean CMT was 353.3?±?75.4??m. After a median follow-up of 3.7 years (range 1-7 years), BCVA declined slowly at 0.012?±?0.003 logMAR units/year, with phakic eyes declining more rapidly than pseudophakic eyes (0.019?±?0.003 vs. 0.010?±?0.004 logMAR units/year). Metamorphopsia, phakic lens status, lamellar hole, and inner nuclear layer cysts were associated with faster visual decline. Cumulative rates of progression to surgery were 2.9, 5.6, 12.2, and 21.1% at years 1-4. Visual symptoms, metamorphopsia, greater CMT, and disruption of outer retinal layers were associated with greater hazard for surgery. CONCLUSION:Eyes with iERM and visual acuity???20/40 experience slow visual decline, with 21% of eyes requiring surgery after 4 years. Clinical and anatomic predictors of vision loss may be distinct from factors associated with earlier surgical intervention.

SUBMITTER: Luu KY 

PROVIDER: S-EPMC6707144 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature