ĐIỀU TRỊ MÀNG TRƯỚC VÕNG MẠC THỨ PHÁT TỪ VIÊM MÀNG BỒ ĐÀO

Abstract

Epiretinal membrane is an abnormal layer composed of proliferating myofibroblastic cells and extracellular matrix on the inner surface of the central retina, along the internal limiting membrane. Epiretinal membrane with or without associated cystoid macular edema, is a common complication of uveitis. Uveitis-related inflammation may persist chronically or occur in periodic flare-ups superimposed on a baseline of ongoing inflammation, leading to cumulative inflammation within the retina, resulting in chronic structural changes and progressive vision loss. Optical coherence tomography has facilitated the detection of epiretinal membrane, deepened our understanding of its pathophysiology, and enabled the identification of prognostic factors for visual recovery following surgery. Vitrectomy combined with membrane peeling is the standard treatment for this condition, aiming to restore retinal structure and visual function, reduce macular edema, minimize uveitis reactivation, and decrease the quantity and/or dosage of anti-inflammatory medications postoperatively. Non-tractional membranes can be monitored, as they do not cause anatomical abnormalities, and vision is usually preserved. Surgical intervention is indicated when there is progressive structural and functional damage involving the central retina, focal attachment, deformation of retinal layers, persistent cystoid macular edema, significant visual impairment, and when conservative strategies have proven ineffective with at least 3 months of preoperative quiescence. However, optimal perioperative control of inflammation is essential to achieving the best outcomes.