Abstract
Purpose :
To assess the rate of epiretinal membrane (ERM) recurrence after the surgical removal and to describe the morphological features of recurrent ERM as well as their clinical course over time. Finally, clinical and optical coherence tomography (OCT) findings were correlated to identify associated risk factors.
Methods :
640 patients who underwent pars plana vitrectomy (PPV) for an ERM at University Eye hospital, Tübingen, Germany between 02/2007 and 05/2017 were included into a retrospective observational study. ERM recurrence was identified by OCT imaging at a first visit within 3 months after surgery and at the last follow-up examination available. ERM extension was classified as “dot-like” (small dot or deposit-like circumscribed ERM), “focal-ERM” (measuring 50 µm or less) and “large ERM” (measuring more than 50 µm). Morphology analysis included if an ERM remnant edge was within the 1.5mm radius of the foveal center, if the membrane was extrafoveal or involved the fovea and if intraretinal cysts were visible at any postoperative visit. OCT endpoints were correlated with patient related clinical parameters and surgery related factors.
Results :
Out of 506 eyes 38% showed OCT signs of an epiretinal membrane at the last available follow up visit (mean follow up period 28.3 months). Large foveal ERM however was only visible in 10% and only 4% of all eyes were reoperated a second time for an epiretinal membrane. An ERM remnant edge, hyperreflective epiretinal dots, small focal ERM and intraretinal cystic spaces were found to be possible risk factors for large foveal ERM recurrence at later timepoints with an odds ratio of 5.66 (95% confidence interval: 2.0-15.99; p=0.003), 3.63 (95% confidence interval: 1.34-9.84; p=0.02), 2.89 (95% confidence interval: 1.21-6.89; p=0.02) and 1.95 (95% confidence interval: 1.06-3.58; p=0.03).
Conclusions :
The recurrence rate depends significantly upon the definition of ERM recurrence. Foveal ERM recurrence is much less frequent than ERM recurrence outside of the fovea. Insufficient peeling with neighboring remnant membrane is an important predisposing factor for clinically relevant foveal ERM recurrence.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.