The primary management for epiretinal membrane (ERM) is membrane peel after pars plana vitrectomy. However, the rates of postoperative recurrence of epiretinal membrane reported range from 10 to 21%. Internal limiting membrane (ILM) peeling combined with ERM removal has been introduced in an attempt to diminish this recurrence. Some studies showed that this method largely prevented the recurrence compared with those without ILM peeling. Conversely, other studies demonstrated that combined ERM and ILM peeling did not provide a lower recurrence rate. Since the ILM is formed by the basal lamina of Muller cells, removal of this structure must be pondered due to possible mechanical and functional damage to those important cells. In this chapter, current data on this topic are covered.
Background:
To describe a patient with branch retinal artery occlusion that was misdiagnosed as normal tension glaucoma (NTG)
Case Presentation:
A female 76-year-old patient presenting inferior nasal visual field scotoma, neuroretinal thinning in the optic disk of the right eye with corresponding atrophy of superior retinal nerve fiber layer in optical coherence tomography (OCT). She was treated with latanoprost eye drops for NTG. However macular OCT angiography showed a localized thinning of the inner retina following the superior temporal branch retinal artery path, along with a superficial and medium capillary plexus reduction and superior macular ganglion cell layer atrophy. Further investigation with carotid arteries angio-tomography revealed an atheromatous lesion in the right and left carotid bulb with stenosis of 50–60%, in addition to aneurysms of the cavernous, pituitary and communicating segments of the left and right internal carotid artery, reinforcing the diagnosis of superior temporal branch retinal artery ischemic.
Conclusion:
This case highlights the importance of establishing differential diagnosis in cases of presumed NTG and reinforces the use of the OCT angiography in clinical practice.
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