Biomedical papers, 2017 (vol. 161), issue 1

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2017, 161(1):100-106 | 10.5507/bp.2016.065

The natural evolution of idiophatic epimacular membrane

Libor Hejseka, Alexandr Stepanova, Alena Dohnalovab, Tereza Rehakovaa, Nada Jiraskovaa
a Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic
b Institute of Physiology, 1st Faculty of Medicine, Charles University in Prague, Czech Republic

Background and Aims: Epiretinal membrane (ERM) refers to a semi-translucent tissue layer found on the inner surface of the retina especially in older people. Surgical treatment remains controversial, optimal timing for such treatment is difficult to determine and data on the natural evolution of this disorder are limited. In this study we evaluated the natural course of idiopathic epimacular membrane in 49 patients (53 eyes).

Materials and Methods: Retrospective evaluation of a group of 49 patients (53 eyes) with idiopathic epimacular membrane confirmed by biomicroscopy, photography and optical coherence tomography (OCT).

Results: Patient age ranged from 51-85 years (median 72). The average follow-up was 21.3 months (± 14). Between the initial and final best corrected visual acuity (BCVA) there was no statistically significant difference although there was a significant tendency to decrease in BCVA (Spearman P=0.05) during the follow-up. Initial BCVA correlated with initial central retinal thickness (CRT), final CRT, final volume, and age. The final BCVA significantly correlated with all parameters measured.

Conclusion: BCVA during follow-up tended to decrease: difference of starting BCVA and final BCVA values depending on the time of monitoring is significant. This we attribute to a slow gradual progression of macular changes. But, initial and final BCVA measurements were not substantially different at the end. Thus, in the absence of any clear signs of ERM progression, we can safely postpone the decision whether to perform PPV.

Keywords: epimacular membrane, natural course, surgery, PPV

Received: June 23, 2016; Accepted: December 19, 2016; Prepublished online: January 13, 2017; Published: March 27, 2017


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