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Risk factors for microcystic macular oedema in glaucoma
  1. Golnoush Mahmoudinezhad1,
  2. Diana Salazar1,
  3. Esteban Morales1,
  4. Peter Tran1,
  5. Janet Lee2,
  6. Jean-Pierre Hubschman2,
  7. Kouros Nouri-Mahdavi1,
  8. Joseph Caprioli1
  1. 1Ophthalmology, Glaucoma, University of California Los Angeles, Los Angeles, CA, USA
  2. 2Ophthalmology, Retina, University of California Los Angeles, Los Angeles, CA, USA
  1. Correspondence to Dr Joseph Caprioli, University of California Los Angeles, Los Angeles, CA 90095, USA; Caprioli{at}


Background/aims To identify clinical characteristics and factors associated with microcystic macular edema (MME) in patients with primary open-angle glaucoma (POAG).

Methods We included 315 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 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 MME is associated with progressive VF loss.

Results 25 out of 315 eyes (7.9%) demonstrated MME. The average (±SD) age and 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 presence of MME. ERM was not associated with the presence of MME (p=0.84) in this cohort. MME was not associated with MD and VFI decay rates (p>0.49).

Conclusions More severe glaucoma and younger age were associated with MME. MME was not associated with faster global VF decay in this cohort. MME may confound monitoring of glaucoma with full macular thickness.

  • glaucoma
  • macula
  • imaging

Data availability statement

Data are available upon reasonable request.

Statistics from

Data availability statement

Data are available upon reasonable request.

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  • Presented at This paper was presented as a poster at the Annual Meeting of the American Glaucoma Society; February 2020; Washington, D.C., Columbia, USA.

  • Contributors Study conception and design: JC and KN-M. Collection of data: GM, DS, PT, EM and JL. Statistical analysis: GM and EM. Interpretation of data: GM, DS, PT, EM, J-PH, KN-M, JC. Writing the article: GM, KN-M and JC. Critical revision of the article, final approval of the article, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: all authors. Guarantor: JC and GM.

  • Funding J-PH: Research to prevent Blindness (No grant #), Hess foundation (No grant #). KN-M: NIH R01 grant (EY027929), an unrestricted Departmental Grant from Research to Prevent Blindness (No grant #), and an unrestricted grant from Heidelberg Engineering (KNM, no grant #). JC: Research to Prevent Blindness, New York, NY (No grant #).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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