Severe glaucoma and younger age associated with microcystic macular edema: Study

A study was conducted to identify clinical characteristics and factors associated with microcystic macular edema (MME) in patients with primary open-angle glaucoma (POAG).

They included 315 primary open-angle glaucomas (POAG) eyes between 2010 and 2019 with good-quality macular volume scans that had reliable visual fields (VF) available within 6 months in this observational retrospective cohort study. Eyes with retinal pathologies except for epiretinal membrane (ERM) were excluded. The inner nuclear layer was qualitatively assessed for the presence of microcystic macular edema (MME). Global mean deviation (MD) and Visual Field Index (VFI) decay rates, superior and inferior MD rates and pointwise total deviation rates of change were estimated with linear regression. Logistic regression was performed to identify baseline factors associated with the presence of MME and to determine whether microcystic macular edema (MME) is associated with progressive VF loss.

Results of the study are:

• 25 out of 315 eyes (7.9%) demonstrated microcystic macular edema (MME).
• The average (±SD) age and mean deviation (MD) in eyes with and without MME was 57.2 (±8.7) versus 62.0 (±9.9) years (p=0.02) and −9.8 (±5.7) versus −4.9 (±5.3) dB (p<0.001), respectively.
• Worse global MD at baseline (p=0.001) and younger age (p=0.02) were associated with the presence of microcystic macular edema (MME).
• ERM was not associated with the presence of MME (p=0.84) in this cohort.
• Microcystic macular edema (MME) was not associated with mean deviation (MD) and Visual Field Index (VFI) decay rates (p>0.49).

Thus, more severe glaucoma and younger age were associated with microcystic macular edema (MME). Microcystic macular edema (MME) was not associated with faster global Visual Field VF decay in this cohort. Microcystic macular edema (MME) may confound monitoring of glaucoma with full macular thickness.

Reference:

Risk factors for microcystic macular oedema in glaucoma by Golnoush Mahmoudinezhad et al. published in the British Journal of Ophthalmology.

doi: 10.1136/bjophthalmol-2021-320137

Keywords:

Golnoush Mahmoudinezha, Diana Salazar, Esteban Morales, Peter Tran, Janet Lee, Jean-Pierre primary open-angle glaucoma (POAG), Microcystic macular edema, MME, retinal pathologies, Visual Field, Visual Field index, decay rates, Hubschman, Kouros Nouri-Mahdavi, Joseph Caprioli, glaucoma, edema, Risk factors, macular, microcystic, British Journal of Ophthalmology