Long-term natural history of idiopathic epiretinal membranes with good visual acuity

Kieu Yen Luu, Tynisha Koenigsaecker, Amirfarbod Yazdanyar, Lekha Mukkamala, Blythe P. Durbin-Johnson, Lawrence S Morse, Ala Moshiri, Susanna Soon Chun Park, Glenn C Yiu

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
JournalEye (Basingstoke)
DOIs
StatePublished - Jan 1 2019

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Epiretinal Membrane
Visual Acuity
Vision Disorders
Lenses
Cysts
Proportional Hazards Models
Biomarkers

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

Cite this

Long-term natural history of idiopathic epiretinal membranes with good visual acuity. / Luu, Kieu Yen; Koenigsaecker, Tynisha; Yazdanyar, Amirfarbod; Mukkamala, Lekha; Durbin-Johnson, Blythe P.; Morse, Lawrence S; Moshiri, Ala; Park, Susanna Soon Chun; Yiu, Glenn C.

In: Eye (Basingstoke), 01.01.2019.

Research output: Contribution to journalArticle

Luu, Kieu Yen ; Koenigsaecker, Tynisha ; Yazdanyar, Amirfarbod ; Mukkamala, Lekha ; Durbin-Johnson, Blythe P. ; Morse, Lawrence S ; Moshiri, Ala ; Park, Susanna Soon Chun ; Yiu, Glenn C. / Long-term natural history of idiopathic epiretinal membranes with good visual acuity. In: Eye (Basingstoke). 2019.
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abstract = "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.",
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AU - Luu, Kieu Yen

AU - Koenigsaecker, Tynisha

AU - Yazdanyar, Amirfarbod

AU - Mukkamala, Lekha

AU - Durbin-Johnson, Blythe P.

AU - Morse, Lawrence S

AU - Moshiri, Ala

AU - Park, Susanna Soon Chun

AU - Yiu, Glenn C

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AB - 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.

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