Natural History of Idiopathic Epiretinal Membrane in Eyes with Good Vision Assessed by Spectral-Domain Optical Coherence Tomography

Abstract

Purpose: To investigate the natural history of idiopathic epiretinal membrane (ERM) in eyes with good visual function using optical coherence tomography (OCT). Methods: Sixty-two eyes of 58 patients with idiopathic ERM, visual acuity of 20/40 or better, and no significant metamorphopsia were included. The best corrected visual acuity (BCVA), central macular thickness (CMT), membrane configuration, and ellipsoid zone signal data over 24 months were retrospectively analyzed. Based on OCT findings, ERM configurations were categorized as global attachment (GA), partial attachment (PA), pseudohole, and vitreomacular traction (VMT). Results: The mean BCVA and CMT did not change significantly between baseline and 24 months. GA, PA, pseudohole, and VMT types were observed in 33, 19, 9, and 1 eye at baseline, and in 20, 22, 10, and 1 eye at 24 months, respectively. A membrane configuration change was noted in 24 eyes (38.7%) during follow-up, and the distribution shifted from GA to the other types (p < 0.001). Six eyes had visual loss due to membrane progression, and 4 eyes had spontaneous membrane separation. Of the 10 eyes with progression or separation, 6 were of the PA type. Conclusions: Although the BCVA remains stable over 2 years in most idiopathic ERM eyes with good visual function at baseline, the membrane configuration may change, affecting visual acuity. The GA type would be an early stage, and the PA type is prone to changes in visual acuity.

A Case of Secondary Epiretinal Membrane Spontaneous Release

“…At the same time, visual functions in the majority of ERM patients with relatively high visual acuity (0.5 and above) remain stable for two years of observation in the absence of treatment, and visual decline occurs in less than 10% of the cases [9]. These data support the watchful waiting strategy chosen for the patient.…”

“…ERM spontaneous separation is rare (3–6%) [7–9], and it is essential to observe this process in the dynamics. Spontaneous ERM release was described in association with toxoplasma uveitis, eye trauma, and laser surgery (pan-retinal photocoagulation and YAG-laser capsulotomy) [7, 10].…”

Spontaneous separation of secondary epiretinal membrane

“…Самостоятельное отделение ЭРМ от сетчатки происходит довольно редко (3-6%) [7,11,12], а отследить этот процесс инструментально в динамике удается в единичных случаях. Спонтанное отделение ЭРМ описано при токсоплазмозном увеите, травме глаза, лазерных вмешательствах (панретинальная коагуляция и YAG-лазерная капсулотомия) [7,13].…”

“…Выбор наблюдательной тактики в отношении пациентки имеет ряд оснований [12,14,15]. Во-первых, по результатам хирургического лечения вторичной ЭРМ, ассоциированной с тромбозом ветви ЦВС, повышение остроты зрения отмечено лишь у 48,5% пациентов [14], в то время как при лечении первичной ЭРМ -в 70% случаев [8].…”

Predicting Progression of Untreated Macular Pucker Using Retinal Surface En Face Optical Coherence Tomography

“…The advent of optical coherence tomography (OCT) has revolutionized the evaluation and management of PMM by providing additional anatomical details and morphological features not available on clinical exami-nations [21,22]. Several OCT studies have proposed disparate frameworks for describing morphologic features associated with PMM, which are summarized in-depth in a review by Stevenson et al [23].…”