Clinical course and surgical treatment of macular epiretinal membranes in young subjects

Abstract

Objective To examine the surgical and nonsurgical visual outcomes of young subjects with idiopathic macular epiretinal membranes (ERMs). Design Retrospective observational and noncomparative interventional case series. Participants Nineteen consecutive subjects (20 eyes) aged 40 years or less with an idiopathic macular ERM. Methods Group 1: 10 consecutive eyes were initially seen with visual acuity of 20/50 or better; 7 eyes were observed, and 3 eyes with progressive visual loss to <20/50 underwent vitrectomy and membrane peeling. Group 2: 10 consecutive eyes with presenting visual acuity of 20/60 or worse underwent vitrectomy and membrane peeling. Main outcome measures Visual acuity, cataract formation, ERM recurrence, operative complications. Results Group 1: With no surgery, visual acuity remained stable or improved in 5 of 10 eyes (50%), with a mean follow-up of 3.7 years. Three of 10 eyes (30%) had visual loss ≤20/60 develop and underwent vitrectomy. Postoperative visual acuity improved an average of 6 lines with a mean follow-up of 17.6 months. Group 2: After vitrectomy, visual acuity improved 2 or more lines in 7 of 10 eyes (70%), with a mean improvement of 4.4 lines and mean follow-up of 29.2 months. Groups 1 and 2: Three of 13 eyes (23%) that underwent vitrectomy had recurrent ERM formation. Conclusions Young subjects with idiopathic macular ERMs and a presenting visual acuity of 20/50 or better had a favorable visual outcome with observation. Subjects with an initial vision of 20/60 or worse, or those who had a visual decrease to ≤20/60 had significantly improved visual acuity after vitrectomy. ERM recurrence is relatively high after surgery.