J Korean Ophthalmol Soc.  2020 Feb;61(2):159-166. 10.3341/jkos.2020.61.2.159.

Clinical Outcomes of Idiopathic Epiretinal Membrane Removal in Patients 80 Years or Older

Affiliations
  • 1Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea. kjh7997@daum.net

Abstract

PURPOSE
To evaluate clinical outcomes of idiopathic epiretinal membrane removal in patients ≥ 80 years of age.
METHODS
A retrospective review of medical records was performed with 56 patients who underwent vitrectomy and removal of idiopathic epiretinal membrane. In the ≥ 80 years of age group (n = 28), the best-corrected visual acuity (BCVA) and central macular thickness (CMT) before surgery were compared with those at the final follow-up. The amount of change in the BCVA after surgery was also compared between the ≥ 80 years of age group and the < 80 years of age group (n = 28).
RESULTS
In the ≥ 80 years of age group, the mean follow-up period was 19.1 ± 17.0 months. Before surgery, 11 eyes were pseudophakic and 17 eyes were phakic. Combined cataract surgery was performed with epiretinal membrane removal in all 17 phakic eyes. The mean logarithm of the minimal angle of resolution BCVA was 0.75 ± 0.30 before surgery, which improved to 0.50 ± 0.30 at the final follow-up (p < 0.001). The CMT was 458.0 ± 79.7 µm before surgery, which decreased to 367.2 ± 83.4 µm at the final follow-up (p < 0.001). There was no significant difference in the amount of change in the BCVA after the surgery between the ≥ 80 years of age group and the < 80 years of age group (p = 0.547).
CONCLUSIONS
In patients with idiopathic epiretinal membrane who were ≥ 80 years of age, the visual acuity was improved or maintained, and was accompanied with anatomical improvement after epiretinal membrane removal with or without cataract surgery. These results suggest the usefulness of epiretinal membrane removal in older patients.

Keyword

Epiretinal membrane; Epiretinal membrane removal; Old

MeSH Terms

Cataract
Epiretinal Membrane*
Follow-Up Studies
Humans
Medical Records
Retrospective Studies
Visual Acuity
Vitrectomy

Figure

  • Figure 1 Horizontal (A) and vertical (B) optical coherence tomography scan images showing method to measure inner-retinal irregularity index. The yellow line indicates inferior border of inner plexiform layer (IPL) and the blue line indicates retinal pigment epithelium (RPE). The inner-retinal irregularity index was calculated as length of inferior border of IPL/length of RPE.

  • Figure 2 Outcomes of 84-year-old patient who was diagnosed with epiretinal membrane and cataract. The best-corrected visual acuity (BCVA) was 0.2 (decimal) before surgery (A, B). The patients underwent combined epiretinal membrane removal and cataract surgery. Five months after the surgery (C, D), the BCVA improved to 0.4 (decimal).

  • Figure 3 Changes in logarithm of minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) of patients who underwent epiretinal membrane removal with or without cataract surgery. There was a significant improvement in BCVA after surgery (p < 0.001). (A) Outcomes in all 28 patients. (B) Comparison of outcome between patients who underwent epiretinal membrane removal only (solid line, n = 11) and patients who underwent combined epiretinal membrane removal and cataract surgery (dotted line, n = 17). Op = operation; F/U = follow-up.

  • Figure 4 Changes in central macular thickness of patients who underwent epiretinal membrane removal with or without cataract surgery. There was a significant decrease in central macular thickness after surgery (p < 0.001). (A) Outcomes in all 28 patients. (B) Comparison of outcome between patients who underwent epiretinal membrane removal only (solid line, n = 11) and patients who underwent combined epiretinal membrane removal and cataract surgery (dotted line, n = 17).


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