Epiretinal membranes in uveitic macular edema: effect on vision and response to therapy.
OBJECTIVE
To evaluate the effects of epiretinal membranes on the response of uveitic macular edema to therapy and on visual acuity outcomes.


METHODS
Retrospective case series.


METHODS
One hundred four eyes of 77 patients with uveitic macular edema were identified at a tertiary care center. Epiretinal membranes were diagnosed when identified by 2 investigators' grading of spectral-domain optical coherence tomography and scored for the presence or absence of surface wrinkling. Outcomes included best-corrected visual acuity, central subfield thickness, and rates of macular edema improvement (>20% reduction in central subfield thickness) and resolution (reduction of central subfield thickness to <315 μm) at 3 and 6 months follow-up.


RESULTS
Seventy-two eyes of 59 patients had an epiretinal membrane on presentation. Eyes without epiretinal membranes and with epiretinal membranes without surface wrinkling were not significantly different at presentation or at 3 and 6 months follow-up. Conversely, eyes with an epiretinal membrane with retinal surface wrinkling had a greater proportion of eyes with 20/200 or worse visual acuity at presentation, and had worse mean acuities at 3 months (20/94 vs 20/35 for eyes without an epiretinal membrane, P = .002) and at 6 months follow-up (20/110 vs 20/36 for eyes without an epiretinal membrane, P = .02). At 6 months of follow-up the mean central subfield thicknesses were: eyes without an epiretinal membrane, 338 ± 23 μm; and eyes with an epiretinal membrane and surface wrinkling, 405 ± 22 μm (P = .05).


CONCLUSIONS
In eyes with epiretinal membranes and retinal surface wrinkling, uveitic macular edema had a poorer visual acuity response to medical therapy and thicker maculae at 6 months.
Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York.
Brian
B
Lehpamer
Department of Biostatistics, Icahn School of Medicine at Mount Sinai, New York, New York.
Erin
E
Moshier
Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York.
Patricia
P
Pahk
Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York.
Naomi
N
Goldberg
Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York.
Jessica
J
Ackert
Department of Biostatistics, Icahn School of Medicine at Mount Sinai, New York, New York.
James
J
Godbold
Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; The Center for Clinical Trials, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: douglas.jabs@mssm.edu.
Douglas A
DA
Jabs
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D058449:Intravitreal Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014605:Uveitis / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D014786:Vision Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology*
D005938:Glucocorticoids; D007166:Immunosuppressive Agents