Epiretinal Membranes in Uveitic Macular Edema: Effect on Vision and Response to Therapy

Abstract

To evaluate the effects of epiretinal membranes on the response of uveitic macular edema to therapy and on visual acuity outcomes. Retrospective case series. One hundred four eyes of 77 patients with uveitic macular edema were identified at a tertiary care center. Epiretinal membranes were diagnosed when identified by 2 investigators' grading of spectral-domain optical coherence tomography and scored for the presence or absence of surface wrinkling. Outcomes included best-corrected visual acuity, central subfield thickness, and rates of macular edema improvement (>20% reduction in central subfield thickness) and resolution (reduction of central subfield thickness to <315μm) at 3 and 6months follow-up. Seventy-two eyes of 59 patients had an epiretinal membrane on presentation. Eyes without epiretinal membranes and with epiretinal membranes without surface wrinkling were not significantly different at presentation or at 3 and 6months follow-up. Conversely, eyes with an epiretinal membrane with retinal surface wrinkling had a greater proportion of eyes with 20/200 or worse visual acuity at presentation, and had worse mean acuities at 3months (20/94 vs 20/35 for eyes without an epiretinal membrane, P= .002) and at 6months follow-up (20/110 vs 20/36 for eyes without an epiretinal membrane, P= .02). At 6months of follow-up the mean central subfield thicknesses were: eyes without an epiretinal membrane, 338 ± 23μm; and eyes with an epiretinal membrane and surface wrinkling, 405 ± 22μm (P= .05). In eyes with epiretinal membranes and retinal surface wrinkling, uveitic macular edema had a poorer visual acuity response to medical therapy and thicker maculae at 6months.