%0 Journal Article
%T Epiretinal membrane surgery for combined hamartoma of the retina and retinal pigment epithelium: role of multimodal analysis
%A Bru¨¨ C
%A Saitta A
%A Nicolai M
%A Mariotti C
%A Giovannini A
%J Clinical Ophthalmology
%D 2013
%I 
%R http://dx.doi.org/10.2147/OPTH.S39909
%X etinal membrane surgery for combined hamartoma of the retina and retinal pigment epithelium: role of multimodal analysis Case Series (785) Total Article Views Authors: Bru¨¨ C, Saitta A, Nicolai M, Mariotti C, Giovannini A Published Date January 2013 Volume 2013:7 Pages 179 - 184 DOI: http://dx.doi.org/10.2147/OPTH.S39909 Received: 03 November 2012 Accepted: 05 December 2012 Published: 20 January 2013 Claudia Bru¨¨, Andrea Saitta, Michele Nicolai, Cesare Mariotti, Alfonso Giovannini Ophthalmology, Department of Neuroscience, Marche Polytechnic University, Ancona, Italy Background: The purpose of this study was to evaluate the role of spectral domain optical coherence tomography (SD-OCT), MP-1 microperimetry, and fundus autofluorescence imaging for planning surgical procedures in combined hamartomas of the retina and retinal pigment epithelium (CHR-RPE) and following epiretinal membrane removal. Methods: In an interventional retrospective case series, six consecutive subjects with CHR-RPE underwent vitrectomy and epiretinal membrane peeling, with 4 years of follow-up. Each underwent complete ophthalmic examination, including best corrected visual acuity, fundus examination, fundus fluorescein angiography, SD-OCT, MP-1, and fundus autofluorescence at one, 6, 12, and 48 months. Results: Six eyes from six subjects with CHR-RPE were studied (mean age 31 ¡À 14 years). All patients were phakic and five were male (83.3%). Lesions were unilateral, ie, three macular, two juxtapapillary and macular, and one pericentral. Preoperative best corrected visual acuity was 0.3 ¡À 0.08 Snellen, with significant improvement to 0.9 ¡À 0.17 Snellen (P = 0.001) at 4 years of follow-up. Mean retinal sensitivity within the central 20¡ã field improved from 16.6 ¡À 1.84 dB to 18.8 ¡À 0.96 dB (P = 0.07). There was also a statistically significant reduction in the visual defect (P = 0.04). SD-OCT demonstrated that the epiretinal membranes were completely removed in all but one patient, with significantly decreased macular edema on follow-up at one, 6, 12, and 48 months (P = 0.001). A positive correlation was shown between preoperative macular sensitivity and postoperative best corrected visual acuity. Fundus autofluorescence demonstrated a block in background autofluorescence at the site of the lesion, and hyperautofluorescsence at the edematous retina overlain by the epiretinal membrane. Conclusion: Surgery is an effective treatment for CHR-RPE. SD-OCT, fundus autofluorescence, and MP-1 are valuable and noninvasive tools to guide surgical procedures for CHR-RPE. To the best of our knowledge, this study represents the first use of MP-1 in CHR-RPE in conjunction with SD-OCT and fundus autofluorescence imaging for better guided surgery as well as anatomical and functional prognosis.
%K vitrectomy
%K epiretinal membrane
%K combined hamartoma of the retina and retinal pigment epithelium
%U https://www.dovepress.com/epiretinal-membrane-surgery-for-combined-hamartoma-of-the-retina-and-r-peer-reviewed-article-OPTH