Introducing 

Prezi AI.

Your new presentation assistant.

Refine, enhance, and tailor your content, source relevant images, and edit visuals quicker than ever before.

Loading…
Transcript

Epiretinal Membrane with Macular Pseudohole

Visual Outcome of Surgery for Epiretinal Membranes with Macular Pseudoholes

Patient Data

Impression and Plan

Objective: Evaluate effect of macular pseudohole on vision after ERM surgery

  • 437 patients w/ ERM had surgery
  • 68 patients had a pseudohole in one eye
  • Results compared to 50 patients w/ no pseudohole that had ERM surgery
  • Pseudohole: 80% had VA of 20/50 or better w/ avg improvement of 2.72 lines
  • No pseudohole: 72% reached VA of 20/50 or better w/ avg improvement of 2.62 lines
  • VA (sc)
  • 20/30 OD, 20/30-2 OS, 20/25-2 OU
  • Manifest
  • OD: +1.00-0.50x82 DVA 20/20
  • OS: +1.50-0.50x105 DVA 20/20
  • NCT 16 OD/OS
  • SLE
  • PVD OS
  • C/D ratio: 0.1 OD/OS
  • ERM, OS

Conclusion

Patient Data

1. Epiretinal Membrane with traction causing macular pseudohole, OS

  • RTC 3 months or prn

2. Hyperopia

  • Gave SRx

3. Astigmatism

4. Presbyopia

OCT OD

Risk Factors

  • Diabetes
  • Hypercholesterolemia
  • Narrower arteriolar caliber
  • 60 yo WF
  • CC: Decreased vision, distance and near x 1 year, OU
  • LEE: 2012
  • Wears +1.75 OTC readers
  • Ocular Hx:
  • Trichiasis, OS
  • Episode of "millions of floaters" 10 years ago, OS
  • Flashes of light occasionally, OS
  • Medical Hx:
  • Hyperlipidemia
  • Hypothyroid
  • Unsure on exact prevalence of ERM but fairly common in elderly population
  • ERMs are frequently asymptomatic and do not require surgery
  • Prognosis is dependent on type of ERM
  • Pseudoholes can disappear after surgery
  • Presence of a pseudohole does not indicate a poor prognosis and VA after surgery is generally good

Epiretinal Membranes

Categories

  • Proliferation of retinal glial cells that have accessed the retinal surface through breaks in ILM

  • Causes:
  • Idiopathic
  • Secondary- following a retinal procedure, vascular disease, intraocular inflammation, or ocular trama

1. Cellophane maculopathy

  • common, secondary to PVD
  • frequently asymptomatic
  • irregular light reflex or sheen at macula
  • not usually treated

2. Macular pucker

  • thickening & contraction of ERM
  • less common
  • metamorphopsia, decreased VA
  • distortion of BVs, white striae
  • macular pseudoholes and/or CME
  • surgical removal
  • Prevalence increased with age but had no difference between men and women

* Other studies have reported overall lower

percentages- attributable to different study

designs, photos, samples, and grading

OCT OS

References

3 months after surgery

  • Pseudohole disappeared from 28 eyes and persisted in 22

6 months after surgery

  • Pseudohole persisted in 15 eyes

* No difference in VA whether

pseudohole persisted or not

Prevalence

1. Ng CH, Cheung N, Wang JJ, et al. Prevalence and Risk Factors for Epiretinal Membranes in a Multi-Ethnic United States Population. Ophthalmology. 2011;118(4):694-699.

2. Massin P, Paques M, Masri H, et al. Visual Outcome of Surgery for Epiretinal Membranes with Macular Pseudoholes. Ophthalmology. 1999; 106(3):580-585.

3. Kanski J. Clinical Ophthalmology A Clinical Approach. 6th ed. Philadelphia: Elsevier, 2007.

Multi-ethnic study

  • 6176 participants from 6 U.S. communities
  • Fundus photos taken and assessed for ERM- classified into 2 categories
  • ERM present in 28.9% of participants; 35% had bilateral ERMs
  • Chinese: 39%
  • Hispanics: 29.3%
  • Whites: 27.5%
  • Blacks: 26.2%
Learn more about creating dynamic, engaging presentations with Prezi