Clinical Outcomes of Idiopathic Epiretinal Membrane Removal in Patients 80 Years or Older

Jae Wook Han; Jong Woo Kim; Chul Gu Kim; Dong Won Lee; Su Jin Yoo; Moon Jung Choi; Young Ju Lew; Hyung Seok Kim; Han Joo Cho; Ju Yeon Kim; Jae Hui Kim

doi:10.3341/jkos.2020.61.2.159

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Han, Kim, Kim, Lee, Yoo, Choi, Lew, Kim, Cho, Kim, and Kim: Clinical Outcomes of Idiopathic Epiretinal Membrane Removal in Patients 80 Years or Older

Original Article

Journal of the Korean Ophthalmological Society 2020; 61(2): 159-166.

Published online: 18 February 2020

DOI: https://doi.org/10.3341/jkos.2020.61.2.159

Clinical Outcomes of Idiopathic Epiretinal Membrane Removal in Patients 80 Years or Older

Jae Wook Han, MD, Jong Woo Kim, MD, Chul Gu Kim, MD, Dong Won Lee, MD, Su Jin Yoo, MD, Moon Jung Choi, MD, Young Ju Lew, MD, Hyung Seok Kim, MD, Han Joo Cho, MD, Ju Yeon Kim, MD, Jae Hui Kim, MD

Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea.

Address reprint requests to Kim Jae Hui, MD. Kim's Eye Hospital, #136 Yeongsin-ro, Yeongdeungpo-gu, Seoul 07361, Korea. Tel: 82-2-2671-7665, Fax: 82-2-2671-6359, kjh7997@daum.net

Received 3 January 2019 Revised 11 March 2019 Accepted 17 January 2020

The Korean Ophthalmological Society

(open-access):

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 evaluate clinical outcomes of idiopathic epiretinal membrane removal in patients ≥ 80 years of age.

Methods

A retrospective review of medical records was performed with 56 patients who underwent vitrectomy and removal of idiopathic epiretinal membrane. In the ≥ 80 years of age group (n = 28), the best-corrected visual acuity (BCVA) and central macular thickness (CMT) before surgery were compared with those at the final follow-up. The amount of change in the BCVA after surgery was also compared between the ≥ 80 years of age group and the < 80 years of age group (n = 28).

Results

In the ≥ 80 years of age group, the mean follow-up period was 19.1 ± 17.0 months. Before surgery, 11 eyes were pseudophakic and 17 eyes were phakic. Combined cataract surgery was performed with epiretinal membrane removal in all 17 phakic eyes. The mean logarithm of the minimal angle of resolution BCVA was 0.75 ± 0.30 before surgery, which improved to 0.50 ± 0.30 at the final follow-up (p < 0.001). The CMT was 458.0 ± 79.7 µm before surgery, which decreased to 367.2 ± 83.4 µm at the final follow-up (p < 0.001). There was no significant difference in the amount of change in the BCVA after the surgery between the ≥ 80 years of age group and the < 80 years of age group (p = 0.547).

Conclusions

In patients with idiopathic epiretinal membrane who were ≥ 80 years of age, the visual acuity was improved or maintained, and was accompanied with anatomical improvement after epiretinal membrane removal with or without cataract surgery. These results suggest the usefulness of epiretinal membrane removal in older patients.

Keywords: Epiretinal membrane, Epiretinal membrane removal, Old

Figures and Tables

Figure 1

Horizontal (A) and vertical (B) optical coherence tomography scan images showing method to measure inner-retinal irregularity index. The yellow line indicates inferior border of inner plexiform layer (IPL) and the blue line indicates retinal pigment epithelium (RPE). The inner-retinal irregularity index was calculated as length of inferior border of IPL/length of RPE.

Figure 2

Outcomes of 84-year-old patient who was diagnosed with epiretinal membrane and cataract. The best-corrected visual acuity (BCVA) was 0.2 (decimal) before surgery (A, B). The patients underwent combined epiretinal membrane removal and cataract surgery. Five months after the surgery (C, D), the BCVA improved to 0.4 (decimal).

Figure 3

Changes in logarithm of minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) of patients who underwent epiretinal membrane removal with or without cataract surgery. There was a significant improvement in BCVA after surgery (p < 0.001). (A) Outcomes in all 28 patients. (B) Comparison of outcome between patients who underwent epiretinal membrane removal only (solid line, n = 11) and patients who underwent combined epiretinal membrane removal and cataract surgery (dotted line, n = 17). Op = operation; F/U = follow-up.

Figure 4

Changes in central macular thickness of patients who underwent epiretinal membrane removal with or without cataract surgery. There was a significant decrease in central macular thickness after surgery (p < 0.001). (A) Outcomes in all 28 patients. (B) Comparison of outcome between patients who underwent epiretinal membrane removal only (solid line, n = 11) and patients who underwent combined epiretinal membrane removal and cataract surgery (dotted line, n = 17).

Table 1

Baseline characteristics of patients ≥80 years of age

Values are presented as mean ± standard deviation or number (%) unless otherwise indicated.

LogMAR = logarithm of minimal angle of resolution.

Table 2

Amount of change in best-corrected visual acuity after surgery

Values are presented as number (%).

LogMAR = logarithm of minimal angle of resolution.

Table 3

Baseline characteristics of patients included in the control groups

Values are presented as mean ± standard deviation or number (%) unless otherwise indicated.

ERM = epiretinal membrane; logMAR = logarithm of minimal angle of resolution.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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