Association Between Aqueous Flare and Epiretinal Membrane in Retinitis Pigmentosa

Abstract

PURPOSE. Epiretinal membrane (ERM) is a frequent macular complication in patients with retinitis pigmentosa (RP). The etiology of ERM formation in RP is largely unknown. The purpose of this study was to investigate the association between aqueous flare, a surrogate index of intraocular inflammation, and ERM secondary to RP. METHODS.We retrospectively studied a total of 206 eyes of 117 patients who were diagnosed with typical RP. Aqueous flare values were measured consecutively in 2012 and 2013 using a laser flare cell meter. Spectral-domain optical coherence tomography images and fundus photographs taken on the same day of the aqueous flare measurements were analyzed for ERM detection. RESULTS.The mean values of aqueous flare, age, and frequency of male sex were significantly higher in the RP patients with ERM compared with the RP patients without ERM (P < 0.0001, P ¼ 0.007, and P ¼ 0.004, respectively). After adjustment for age and sex, the eyes in the highest quartile of aqueous flare had significantly higher odds of having ERM than those in the lowest quartile (odds ratio [OR], 2.68; 95% confidence interval [CI], 1.04-6.93), and the linear trend across flare levels was significant (P ¼ 0.005). In addition, each 1-log-transformed increase in flare values was associated with an elevation of the likelihood of having ERM (OR, 2.59; 95% CI, 1.33-5.06).CONCLUSIONS. Our analysis demonstrated that elevated aqueous flare is associated with ERM secondary to RP, suggesting that inflammation may be implicated in the pathogenesis of ERM formation in RP.

Risk Factors for Posterior Subcapsular Cataract in Retinitis Pigmentosa

“…The aqueous flare was measured with a Kowa FM-600 laser flare meter (Kowa, Nagoya, Japan) as described in our previous studies. 12,13 Flare values were obtained 30 minutes after pupillary dilation with 0.5% tropicamide and 5% phenylephrine hydrochloride. Five measurements were taken and averaged in each eye.…”

Correlation between aqueous flare and residual visual field area in retinitis pigmentosa

“…Visual acuity can also be affected by the development of various types of macular complications, such as epiretinal membrane, cystoid macular oedema, macular hole, vitreomacular traction and macular degeneration, which generate further variation in central visual function 9 10. Many of these macular complications are also observed in other intraocular inflammatory diseases, such as uveitis,11 and the modest inflammation that accompanies RP12 may also contribute to macular pathology 13…”

Ocular abnormalities in a large Western China patient cohort with Retinitis Pigmentosa

“…The mechanisms of ERM formation remains unclear. However, it may include (1) idiopathic preretinal glial cell proliferation, (2) in ammation revealed by elevated aqueous are, and (3) chronic macular-vitreous traction [15][16][17]. Our results demonstrated that CME was the second most common macular abnormality, and this coincided with results from an Italian population for which Testa et al investigated macular abnormalities in 581 RP subjects [1] and found that the most frequent abnormalities was CME (20.4% eyes), followed by ERM (15.6%), VMT (5%), and MH (2%).…”