Journal List > J Korean Ophthalmol Soc > v.52(11) > 1008923

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Lee, Lee, Kim, Kim, Yu, and Kwak: Prognostic Factors in Vitrectomy for Macular Epiretinal Membrane
Original Article

J Korean Ophthalmol Soc 2011;52(11):1302-1307.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.11.1302

Prognostic Factors in Vitrectomy for Macular Epiretinal Membrane

Pyung Lee, MD1, Tae Gon Lee, MD2, Moo Sang Kim, MD3, Eung Suk Kim, MD4, Seung Young Yu, MD, PhD1, Hyung Woo Kwak, MD, PhD1

1Department of Ophthalmology, Kyung Hee University School of Medicine, Seoul, Korea

2Department of Ophthalmology, College of Medicine, Konyang University, Daejeon, Korea

3Department of Ophthalmology, Inje University College of Medicine, Busan, Korea

4Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea

Address reprint requests to Seung Young Yu, MD, PhD Department of Ophthalmology, Kyung Hee Medical Center #1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea Tel: 82-2-958-8451, Fax: 82-2-966-7340, E-mail: syyu@khu.ac.kr

Received 20 April 2010       Revised 11 April 2011       Accepted 26 August 2011

Copyright © 2011 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To identify prognostic factors associated with a favorable outcome after vitrectomy for patients with macular epiretinal membrane (ERM).

Methods

The authors retrospectively reviewed the records of 63 patients (64 eyes) with macular ERM, who were treated by vitrectomy between 2003 and 2008, and followed for more than 6 months.

Results

The mean follow-up period was 13.21 ± 9.11 months and the mean best corrected visual acuity after vitrectomy was log MAR 0.32 ± 0.34. Univariate analysis revealed the patients in the group with a postoperative log MAR of 0.3 or better had better preoperative visual acuity and shorter symptom duration; multivariate analysis revealed the same results. In 24 eyes, intraretinal structures which contained pseudoholes, intraretinal cysts, retinal folds and vitreoretinal traction were analyzed with Cirrus HD-OCT, however, there was no correlation with visual acuity after vitrectomy.

Conclusions

The present study demonstrated vitrectomy for macular ERM resulted in favorable visual improvement. The preoperative visual acuity and symptom duration were a significant prognostic factor.

Keywords: Cirrus HD-OCT, Macular epiretinal membrane, Prognostic factors

References

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Figure 1.
The intraretinal structures of patients with macular ERM in Cirrus-HD OCT. (A) Pseudohole at fovea, (B) Diffuse retinal thickening of retina with globally adherent ERM, (C) Retinal fold with partially adherent ERM, (D) Vitreomacular traction with macular edema.
jkos-52-1302f1.tif
Table 1.
Postoperative visual outcome (log MAR)
Visual Acuity change Number of eyes (%)
Improved ≥ 2 lines 46 (71.8)
Improved < 2 lines 11 (17.2)
Unchanged 5 (7.8)
Worsened 2 (3.2)
Table 2.
Results of univariate analysis (independent t-test)
Factors Postoperative BCVA* (mean ± SD, log MAR)
> 0.3 ≤ 0.3 p-value†
Preoperative visual acuity (log MAR) 0.47 ± 0.32 0.89 ± 0.56 0.001
Age (yr) 66.58 ± 6.97 65.50 ± 8.96 0.588
Symptom duration (mon) 7.32 ± 6.53 14.28 ± 13.09 0.012
Preoperative macular thickness (μ m) 367.94 ± 143.64 388.56 ± 171.48 0.602

* BCVA = best corrected visual acuity

† p-value: statistical significance was calculated by independent t-test.

Table 3.
Results of univariate analysis (Chi-square)
Factors Postoperative BCVA* (log MAR)
> 0.3 ≤ 0.3 p-value†
Sex (M/F) 10/24 7/23 0.777
Etiology (primary/secondary) 16/18 16/14 0.401
Gas tamponade (yes/no) 15/19 16/14 0.617
ILM‡ peeling (yes/no) 6/28 6/24 1.000

* BCVA = best corrected visual acuity

† p-value: statistical significance was calculated by Chi-square

‡ ILM = internal limiting membrane.

Table 4.
Results of multiple linear regression analysis
Factors p-value*
Age 0.424
Sex 0.328
Etiology 0.831
Preoperative visual acuity 0.000
Symptom duration 0.000
Gas tamponade 0.781
ILM† peeling 0.305
Preoperative macular thickness (μ m) 0.979

* p-value: statistical significance was calculated by multiple linear regression

† ILM = internal limiting membrane.

Table 5.
Prognostic factors based on Cirrus-HD OCT findings
Factors Postoperative BCVA* (log MAR)
> 0.3 ≤ 0.3 p-value†
Pseudohole (yes/no) 12/4 7/1 0.631
Retinal thickening (yes/no) 12/4 5/3 0.647
Retinal folding (yes/no) 5/11 3/5 1.000
Vitreomacular traction (yes/no) 12/4 6/2 1.000

* BCVA = best corrected visual acuity

† p-value: statistical significance was calculated by crosstabulation analysis.

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