J Korean Ophthalmol Soc.  2019 Dec;60(12):1216-1222. 10.3341/jkos.2019.60.12.1216.

The Clinical Characteristics of Spontaneous Separated Idiopathic Epiretinal Membrane

• Kang DH
• Lee SH

• KMID: 2466173
• DOI: http://doi.org/10.3341/jkos.2019.60.12.1216

Abstract

PURPOSE
To investigate the clinical characteristics of spontaneous separation of idiopathic epiretinal membrane (ERM) patients without any surgical treatment.
METHODS
Retrospective medical records analysis was performed for patients with spontaneous separation of the idiopathic ERM without treatment. The patients' age, average time until ERM separation, best-corrected visual acuity (BCVA), refractive error, intraocular pressure (IOP), optical coherence tomography (OCT) data, central macular thickness (CMT), and the presence of posterior vitreous detachment (PVD) were evaluated and recorded.
RESULTS
Twenty-two eyes of 22 patients were included in the study. The mean age of patients was 52.0 ± 8.6 years, and the average time until ERM separation was 14.1 ± 16.2 months. The average BCVA (logMAR) was 0.12 ± 0.12 before separation and improved (p = 0.032) to 0.07 ± 0.08 after separation. The average CMT before separation was 386.1 ± 63.2 µm, after separation, the average CMT decreased (p < 0.001) to 299.1 ± 46.7 µm. The differences in IOP and refractive error before and after ERM separation were not statistically significant. Not all patients experienced PVD before ERM separation, however, they all showed PVD after the separation.
CONCLUSIONS
ERM patients of a relatively young age and without PVD showed spontaneous separation of the ERM and improved visual acuity with PVD, which suggests that ERM could be improved through conservative observation without surgery.

Keyword

Epiretinal membrane; Foveal thickness; Optical coherence tomography; Spontaneous separation; Visual acuity

MeSH Terms

Epiretinal Membrane*
Humans
Intraocular Pressure
Medical Records
Refractive Errors
Retrospective Studies
Tomography, Optical Coherence
Visual Acuity
Vitreous Detachment

Figure

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  Figure 1. Opticalcoherence tomography images of macula with epiretinal membrane (A), and after spontaneous separation of epiretinal membrane in same eye (B). The central macular thickness decreased from 491 μ m to 297 μ m, and the patient's visual acuity (logMAR) was improved from 0.4 to 0.05. logMAR = logarithm of minimal angle of resolution.

• 

  Figure 2. Opticalcoherence tomography images of macula with posterior vitreous adhesion (arrows) and epiretinal mem-brane (A), and posterior vitreous detachment (arrowheads) with spontaneous separated epiretinal membrane (B). The central macular thickness decreased from 337 μ m to 275 μ m.

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  Figure 3. Fundus photograph (A, B) and opticalcoherence tomography images (C, D). Epiretinal membrane was shown at baseline images (A, C), and large floater (arrows) appeared after spontaneous separation of epiretinal membrane (B, D). The central macular thickness decreased from 401 μ m to 298 μ m.

Reference

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