title: Spectral domain optical coherence tomography characterization of pediatric epiretinal membranes.
abstract: OBJECTIVE
  To compare the macular morphology of pediatric versus adult eyes with epiretinal membrane (ERM) using spectral domain optical coherence tomography and identify characteristics associated with postoperative visual acuity.
  
  
  METHODS
  This retrospective study analyzed spectral domain optical coherence tomography from pediatric subjects and a randomly selected cohort of adult subjects with ERM. Morphologic retinal and ERM features were graded by two masked spectral domain optical coherence tomography readers and compared with a postoperative change in visual acuity.
  
  
  RESULTS
  Pediatric ERMs (age, 0.3-16.5 years) were more confluently attached to the retina than adult ERMs (age, 40-88 years; P = 0.009) and had less fibrillary appearance of the inner retina when separation was present (P = 0.044). Pediatric ERMs were associated with more vessel dragging (P = 0.019) and less external limiting membrane (P = 0.001) and inner segment band visibility (P = 0.010), with a trend toward foveal sparing by ERM (P = 0.051) and "taco" retinal folds (P = 0.052) compared with adult eyes. Visual acuity improvement was associated with intact (P = 0.048) and smooth (P = 0.055, trend) inner segment band in children and with smooth inner segment band (P = 0.083, trend) and visible external limiting membrane (P = 0.098, trend) in adults.
  
  
  CONCLUSIONS
  We identified morphologic differences between pediatric and adult ERM on spectral domain optical coherence tomography. Similar to adults, photoreceptor integrity with pediatric ERM seems to predict better visual acuity changes after surgical ERM removal.
authors.affiliation: Departments of *Ophthalmology, Duke University Medical Center, and †Biomedical Engineering, Duke University, Durham, NC.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Rothman
authors.forename: Francisco A
authors.initials: FA
authors.lastname: Folgar
authors.forename: Amy Y
authors.initials: AY
authors.lastname: Tong
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Toth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D019773:Epiretinal Membrane / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy