Long-term natural history of idiopathic epiretinal membranes with good visual acuity.
Journal
Eye (London, England)
ISSN: 1476-5454
Titre abrégé: Eye (Lond)
Pays: England
ID NLM: 8703986
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
12
06
2018
accepted:
24
11
2018
revised:
08
11
2018
pubmed:
20
4
2019
medline:
23
5
2020
entrez:
20
4
2019
Statut:
ppublish
Résumé
To evaluate the long-term progression of idiopathic epiretinal membranes (iERMs) with good baseline visual acuity, and to identify predictors of visual decline. Retrospective case series SUBJECTS METHODS: We reviewed records of 145 eyes with iERM and best-corrected visual acuity (BCVA) of 20/40 or greater at presentation, including BCVA, lens status, and central macular thickness (CMT) at yearly visits; as well as anatomic biomarkers including vitreomacular adhesion, pseudohole, lamellar hole, intraretinal cysts, disorganization of the inner retinal layers (DRIL), and disruption of outer retinal layers. Linear mixed effects and mixed-effects Cox proportional hazards models were used to identify clinical and anatomic predictors of vision change and time to surgery. At presentation, mean BCVA was 0.17 ± 0.10 logMAR units (Snellen 20/30) and mean CMT was 353.3 ± 75.4 μm. After a median follow-up of 3.7 years (range 1-7 years), BCVA declined slowly at 0.012 ± 0.003 logMAR units/year, with phakic eyes declining more rapidly than pseudophakic eyes (0.019 ± 0.003 vs. 0.010 ± 0.004 logMAR units/year). Metamorphopsia, phakic lens status, lamellar hole, and inner nuclear layer cysts were associated with faster visual decline. Cumulative rates of progression to surgery were 2.9, 5.6, 12.2, and 21.1% at years 1-4. Visual symptoms, metamorphopsia, greater CMT, and disruption of outer retinal layers were associated with greater hazard for surgery. Eyes with iERM and visual acuity ≥ 20/40 experience slow visual decline, with 21% of eyes requiring surgery after 4 years. Clinical and anatomic predictors of vision loss may be distinct from factors associated with earlier surgical intervention.
Sections du résumé
BACKGROUND/OBJECTIVES
To evaluate the long-term progression of idiopathic epiretinal membranes (iERMs) with good baseline visual acuity, and to identify predictors of visual decline.
DESIGN
Retrospective case series SUBJECTS METHODS: We reviewed records of 145 eyes with iERM and best-corrected visual acuity (BCVA) of 20/40 or greater at presentation, including BCVA, lens status, and central macular thickness (CMT) at yearly visits; as well as anatomic biomarkers including vitreomacular adhesion, pseudohole, lamellar hole, intraretinal cysts, disorganization of the inner retinal layers (DRIL), and disruption of outer retinal layers. Linear mixed effects and mixed-effects Cox proportional hazards models were used to identify clinical and anatomic predictors of vision change and time to surgery.
RESULTS
At presentation, mean BCVA was 0.17 ± 0.10 logMAR units (Snellen 20/30) and mean CMT was 353.3 ± 75.4 μm. After a median follow-up of 3.7 years (range 1-7 years), BCVA declined slowly at 0.012 ± 0.003 logMAR units/year, with phakic eyes declining more rapidly than pseudophakic eyes (0.019 ± 0.003 vs. 0.010 ± 0.004 logMAR units/year). Metamorphopsia, phakic lens status, lamellar hole, and inner nuclear layer cysts were associated with faster visual decline. Cumulative rates of progression to surgery were 2.9, 5.6, 12.2, and 21.1% at years 1-4. Visual symptoms, metamorphopsia, greater CMT, and disruption of outer retinal layers were associated with greater hazard for surgery.
CONCLUSION
Eyes with iERM and visual acuity ≥ 20/40 experience slow visual decline, with 21% of eyes requiring surgery after 4 years. Clinical and anatomic predictors of vision loss may be distinct from factors associated with earlier surgical intervention.
Identifiants
pubmed: 31000833
doi: 10.1038/s41433-019-0397-z
pii: 10.1038/s41433-019-0397-z
pmc: PMC6707144
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
714-723Subventions
Organisme : NEI NIH HHS
ID : K08 EY026101
Pays : United States
Organisme : NEI NIH HHS
ID : K08 EY027463
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001860
Pays : United States
Références
Eye (Lond). 2014 Apr;28(4):410-4
pubmed: 24406414
Ophthalmology. 2003 Jan;110(1):34-40
pubmed: 12511343
Graefes Arch Clin Exp Ophthalmol. 2013 Dec;251(12):2681-8
pubmed: 23680863
Am J Ophthalmol. 2000 Nov;130(5):677-9
pubmed: 11078854
Graefes Arch Clin Exp Ophthalmol. 2015 Jan;253(1):47-56
pubmed: 24859385
Retina. 2009 Sep;29(8):1119-27
pubmed: 19734764
Exp Eye Res. 2018 Mar;168:69-76
pubmed: 29352993
Am J Ophthalmol. 1999 Jun;127(6):688-93
pubmed: 10372879
Ophthalmologica. 2015;234(2):91-100
pubmed: 26302864
Diabetes. 2015 Jul;64(7):2560-70
pubmed: 25633419
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2017 Mar;161(1):100-106
pubmed: 28096551
Invest Ophthalmol Vis Sci. 2011 Mar 18;52(3):1486-92
pubmed: 21071737
Curr Eye Res. 2016 Oct;41(10):1387-1392
pubmed: 26862944
Am J Ophthalmol. 2018 Apr;188:29-40
pubmed: 29360459
Ophthalmology. 2013 Dec;120(12):2611-2619
pubmed: 24053995
Graefes Arch Clin Exp Ophthalmol. 2007 Nov;245(11):1623-31
pubmed: 17479277
Ophthalmology. 2014 Aug;121(8):1572-8
pubmed: 24755005
Invest Ophthalmol Vis Sci. 2015 Jun;56(6):4129-34
pubmed: 26114491
Eye (Lond). 2011 Jun;25(6):775-83
pubmed: 21436847
Invest Ophthalmol Vis Sci. 2012 Dec 07;53(13):8042-8
pubmed: 23111607
Am J Ophthalmol. 2004 Nov;138(5):732-9
pubmed: 15531306
Retina. 2014 Dec;34(12):2317-35
pubmed: 25360790
JAMA Ophthalmol. 2014 Nov;132(11):1309-16
pubmed: 25058813
Retina. 2000;20(6):587-90
pubmed: 11131409
JAMA Ophthalmol. 2018 Feb 1;136(2):202-208
pubmed: 29327033
Am J Ophthalmol. 2017 May;177:116-125
pubmed: 28237411
Am J Ophthalmol. 2012 Apr;153(4):710-7, 717.e1
pubmed: 22137207
Br J Ophthalmol. 2016 May;100(5):688-92
pubmed: 26377411
Am J Ophthalmol. 2011 Jun;151(6):973-80
pubmed: 21457925
Ophthalmology. 2013 Sep;120(9):1860-70
pubmed: 23642377