Purpose:
To study the epiretinal membrane (ERM) profile on the spectral-domain optical coherence tomography (SDOCT) in eyes with uveitis.
Methods:
In this prospective observational study, macula of uveitic eyes were evaluated by SDOCT (Cirrus, model 5000) for ERM. ERM was quantified (in microns) and were followed up along with the best-corrected visual acuity (BCVA) and treatment profile for 1 year. ERM morphology (focal, global, or mixed) and characteristics (thickness at fovea, maximum thickness, and location of maximum thickness in relation to fovea) were documented. Changes in altered foveal contour, cystoid macular edema (CME), and central foveal thickness were also noted. BCVA was noted when the inflammation subsided and it was correlated to specific ERM characteristics. SDOCT characteristics were compared in three treatment groups (no oral steroids, oral steroids with, and without immunomodulators).
Results:
Thirty-four eyes of 25 patients were evaluated. Mean logMAR BCVA decreased from 0.25 to 0.35 (
P
= 0.005). Foveal involvement with ERM (
P
= 0.011), lost foveal contour (
P
= 0.043), and ellipsoid layer disruption (
P
= 0.017) were associated significantly with reduced BCVA. Focal attachment of ERM was more commonly associated with CME (
P
= 0.03). Median ERM thickness showed significant increase (
P
< 0.001). Significant ERM progression from parafoveal to foveal (
P
= 0.02), significant progression of the thickest area of ERM closer to fovea (
P
= 0.0006) indicated a strong tendency of foveal involvement and this was correlated with worse BCVA (
P
= 0.009,
r
= −0.44) Oral steroids/immunomodulators showed no significant benefit on ERM progression.
Conclusion:
ERM progression in uveitis has a tendency to involve the fovea and is associated with significant vision loss, particularly in foveal ERM, focal attachment, and IS-OS disruption. Oral steroids and immunomodulators have no role in halting progression.
Purpose:
Morning glory disc anomaly (MGDA) is associated with a high prevalence of retinal detachment (RD), sometimes requiring multiple surgeries. The study aimed to establish the outcomes of RD surgery in such eyes and predict factors influencing the outcome, if any.
Methods:
It was a retrospective observational study of 9 eyes that underwent pars plana vitrectomy (PPV) for RD associated with MGDA. Clinical and surgical details were correlated with outcomes of surgery as noted at the final follow-up.
Results:
PPV was performed in 9 eyes. Lensectomy was done in 5 of 9 eyes (55.5%) during PPV. Laser photocoagulation around the disc was performed in 55.5% (5/9) of the eyes. Silicone oil tamponade was used in 77.7% (7/9) of eyes and gas tamponade (14% C3F8) was used in 22.3% (2/9) of eyes. Attached retina at final visit was observed in 66% of the eyes (6/9). Two out of 3 eyes that were seen to have preoperative glial tissue at the disc had poor outcome (odds ratio 10,
P
= 0.16). Five out of 7 (71%) eyes that had silicone oil tamponade, had an attached retina. No identifiable breaks were noted preoperatively in 5 eyes, of which 4 (80%) had an attached retina postoperatively. Vision improved by 1 line in 67% of the eyes that underwent surgery.
Conclusion:
MGDA related RD presents a unique set of challenges; meticulous PPV with or without lensectomy can help in achieving a successful anatomical and functional outcome in about two-thirds of patients.
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