Epiretinal membrane with surface wrinkling hinders uveitic macular edema treatment

Uveitic macular edema had a poorer response to medical therapy at six months in eyes with epiretinal membranes and retinal surface wrinkling.

This retrospective study found that eyes with epiretinal membranes and retinal surface wrinkling had thicker uveitic macular edema and worse visual acuity six months after medical therapy initiation.

The authors reviewed the charts of 77 patients (104 eyes) with uveitic macular edema identified at a tertiary care center. Epiretinal membranes were diagnosed when identified by two investigators grading spectral-domain optical coherence tomography and scored for the presence or absence of surface wrinkling.

Seventy-two eyes of 59 patients had an epiretinal membrane on presentation. Eyes without epiretinal membranes or with epiretinal membranes without surface wrinkling were not significantly different at presentation or at three and six months’ follow-up.

Conversely, a greater proportion of eyes with an epiretinal membrane with retinal surface wrinkling had 20/200 or worse visual acuity at presentation, and had worse mean acuities at three months’ (20/94 vs. 20/35 for eyes without an epiretinal membrane, P = 0.002) and six months’ follow-up (20/110 vs. 20/36 for eyes without an epiretinal membrane, P = 0.02).

At six months’ follow-up, mean central subfield thicknesses was 338 ± 23 μm in eyes without an epiretinal membrane compared to 405 ± 22 μm (P = 0.05) in eyes with an epiretinal membrane and surface wrinkling.