Abstract
BackgroundTo evaluate the efficacy of epiretinal membrane removal in patients with good best-corrected visual acuity (BCVA) for improving visual function and quality of life (QOL).MethodsThis prospective case study compared 37 subjects with preoperative BCVA ≦ 0.046 logMAR (Good group) to 35 patients with 0.10–0.52 logMAR (Moderate group) at 3 and 6 months. Linear mixed-effect models were used for statistical analysis. The primary outcome was the horizontal metamorphopsia score (MH) at 6 months postoperatively (post-6 M), while secondary outcomes were postoperative BCVA, vertical metamorphopsia score (MV), aniseikonia, stereopsis and central foveal thickness. In the Good group, QOL was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) at 6 and 12 months.ResultsMH was significantly improved at post-3 M and post-6 M in the both groups but there were no significant differences between the two groups. MV showed no improvement at the final observation in either group. LogMAR BCVA was significantly improved at post-6 M in the Good group, which had significantly better vision than the Moderate group. Preoperative vertical and horizontal aniseikonia scores remained unchanged in the Good group at post-6 M but worsened in the Moderate group. The NEI VFQ-25 score improved in the Good group, reflecting improved general health, general vision, and mental health.ConclusionsEarly epiretinal surgery for patients with BCVA ≦ 0.046 logMAR was effective for improvement of HM, BCVA, and QOL and prevented worsening of aniseikonia.Trial registrationUMIN000021220. Registered 10 September 2015.UMIN Clinical Trials Registry.
Highlights
Epiretinal membrane is a translucent tissue that develops on the retinal surface and is reportedly present in 7%–11.8% individuals age 40 years and older [1, 2]
LogMAR best-corrected visual acuity (BCVA) was significantly improved at post-6 M in the Good group, which had significantly better vision than the Moderate group
Preoperative vertical and horizontal aniseikonia scores remained unchanged in the Good group at post-6 M but worsened in the Moderate group
Summary
Epiretinal membrane is a translucent tissue that develops on the retinal surface and is reportedly present in 7%–11.8% individuals age 40 years and older [1, 2]. Epidemiological studies conducted on the Japanese population have found that 4.0%–5.4% of individuals have epiretinal membranes, indicating that aging is a risk factor [3, 4]. A recent study utilizing optical coherence tomography showed an epiretinal membrane to be present in 8.6% of post-cataract surgery patients with a mean age of 74.9 years [5]. Patients with epiretinal membrane will increase as the population ages. The epiretinal membrane itself does not cause blindness, symptoms of metamorphopsia and aniseikonia will develop. Important visual functions other than BCVA, including metamorphopsia, aniseikonia, and binocular vision, have received increasing attention. Okamoto et al reported that metamorphopsia has a greater effect on vision-related quality of life (QOL) than BCVA [9]
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