Evolution of Subfoveal Detachments Secondary to Idiopathic Epiretinal Membranes after Surgery

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• 作者：Auré ; lie Pison ; MD¹ ; ^&lowast ; ; Bé ; né ; dicte Dupas ; MD² ; ^&lowast ; ; ^{benedicte.dupas@aphp.fr" class="auth_mail" title="E-mail the corresponding author} ; Aude Couturier ; MD² ; Pierre-Raphaë ; l Rothschild ; MD³ ; Ramin Tadayoni ; MD ; PhD²
• 关键词：BCVA ; best-corrected visual acuity ; CMT ; central macular thickness ; ERM ; epiretinal membrane ; logMAR ; logarithm of the minimum angle of resolution ; SD ; subfoveal detachment ; SD OCT ; spectral-domain optical coherence tomography ; VA ; visual acuity
• 刊名：Ophthalmology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：123
• 期：3
• 页码：583-589
• 全文大小：2012 K

文摘

To study the characteristics of subfoveal abnormalities secondary to idiopathic epiretinal membranes (ERM) using improved-resolution spectral-domain optical coherence tomography (SD OCT) and their evolution after surgery.

Design

Retrospective, observational cohort study.

Participants

The files of 344 patients operated on consecutively for ERM over a 2-year period in a single tertiary ophthalmologic center were reviewed. Patients with vitreomacular traction syndrome, secondary ERM, or both were excluded.

Methods

In all, 293 eyes with idiopathic ERM were included in the final analysis. Fundus photographs were reviewed to assess the presence of a yellow foveal spot, and SD OCT analysis was performed.

Main Outcome Measures

Presence or absence of a subfoveal abnormality and its SD OCT characteristics before and after surgery at 1 month, 3 months, and at final visit; best-corrected visual acuity (BCVA) and central macular thickness at baseline, 1 month, 3 months, and at the final visit.

Results

Before surgery, a subfoveal detachment (SD) corresponding to the yellow deposit was present in 59 of 293 eyes (20%). No difference was found for the postoperative BCVA between the 59 eyes with SD before surgery and the 234 eyes without SD (0.253 ± 0.14 logarithm of the minimum angle of resolution [logMAR] vs. 0.262 ± 0.24 logMAR, respectively; P = 0.6). Sixty-eight percent (n = 40/59) of SD disappeared after surgery during a mean follow-up of 4.8 ± 3.2 months, most of them (62%) before month 3. Among eyes with preoperative SD, no difference was found for the postoperative BCVA between eyes with disappeared SD and those with persistent SD.

Conclusions

Subfoveal detachments secondary to idiopathic ERM were observed in 20% of these eyes. They disappeared after surgery in more than two thirds of cases, usually early during postoperative course. Subfoveal detachments do not affect visual outcome and should not interfere with surgical decision making.