First Author: M.L.Colaço PORTUGAL
Co Author(s): R. Pinto S. Silva S. Barrão J. Nascimento 0 0 0 0 0 0 0 0 0
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To report a case of bilateral subfoveal deposits associated with bilateral epiretinal membrane with different morphologic and functional outcomes in spite of the same treatment.
Dr. Gama Pinto Institute of Ophthalmology, department of Vitreous and Retinal surgery
A 67-year old man presented with progressive bilateral visual loss and metamorphopsiae associated with bilateral epiretinal membrane. Vision was 20/25 in the right eye and 20/80 in the left eye. The HD-OCT confirmed the presence of a membrane associated with yellow subfoveal deposits above the RPE and disorganization of the outer retina. A subtenon triamcinolone injection followed by pars plana vitrectomy and membrane peeling were performed in the left eye; and the latter procedure was also carried out in the right eye 1 year later.
The left eye showed an excellent response to treatment. Final visual acuity four months postoperatively was 20/20. In the right eye - initially with the better vision - the subfoveal deposits resolved spontaneously prior to surgery and the final visual outcome was 20/80.
The natural history of subfoveal deposits associated with epiretinal membranes is still poorly understood. We consider this report as evidence that subfoveal deposits sometimes seen with epiretinal membranes may signal important changes in photoreceptor-RPE metabolism. There may be an initial inflammatory stage where prompt surgery leads to good visual recovery followed by a later stage where photoreceptors can no longer regenerate and recover despite surgical repair. An early surgical intervention would thus seem appropriate in these cases.