Abstract
Purpose :
Cystoid macular edema (CME) is a post-operative complication of rhegmatogenous retinal detachment (RRD) repair which can affect visual acuity. Data showing predictors of CME development and resolution are limited. The purpose of this study is to identify predictors of CME development and resolution, and the relationship between the formation of epiretinal membrane (ERM) and CME development/resolution.
Methods :
Retrospective review of patients who underwent primary repair of uncomplicated RRD was conducted. Patients were identified as having CME or ERM if a documented diagnosis by the clinician was made and an independent reviewer confirmed the presence of CME or ERM on optical coherence tomography (OCT). Demographics, ophthalmologic history, visual acuity, features of RRD, time to development/resolution of CME, OCT characteristics of CME/ERM, type of surgery, treatments, and visual acuity were collected. Univariable logistic regressions were used to identify predictors of CME resolution.
Results :
A total of 708 eyes were included, of which 55 (7.8%) developed CME. Compared to patients who did not develop CME, patients who developed CME were older (mean [SD]: 63.9 [10.0] vs. 57.1 [12.6] years, p <0.001), more likely to have prior intraocular surgery (65.5% vs. 43.5%, p = 0.003), and less likely to have scleral buckle (SB) surgery (20.0% vs. 39.1%, p = 0.006). Variables associated with CME resolution included the average time to development of CME (OR 0.94 [0.89, 0.997], p = 0.04), foveal involvement (OR 3.25 [1.03, 10.28], p = 0.045), and extent of retinal detachment (OR 0.40 [0.17, 0.97], p = 0.042). In patients who developed an ERM post-surgically, those who developed CME after ERM had a lower rate of resolution compared to those who developed CME before ERM (p=0.03).
Conclusions :
CME may be less likely to develop in patients undergoing SB compared to pars plana vitrectomy (PPV). Resolution of CME may be affected by the time to development of CME, a greater extent of retinal detachment, and ERM development, which could influence future development of CME therapies.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.