Abstract
Purpose :
Epiretinal membrane (ERM) formation is a known and treatable complication of retinal detachment (RD) repairs. We performed a retrospective, observational study to further describe and understand ERM formation during the post operative period.
Methods :
A retrospective chart review of 55 eyes with history of RD repair and subsequent ERM removal by membrane peel (MP) within 1 year between June 1, 2015 and June 1, 2022 at a private retina practice was completed. Exclusion criteria included extensive proliferative vitreoretinopathy (PVR) at the time of RD, need for oil placement, formation of PVR post operatively leading to subsequent RD, epiretinal proliferation, and cystoid macular edema necessitating topical therapy post RD.
The primary outcomes were assessing the visual outcomes in terms of time from RD repair to MP and assessing the grade of the developing ERM. Ocular coherence tomography (OCT) were used to grade ERMs from 1-4 using the standard criteria by a single physician. Secondary outcome was to determine whether macular status at the time of the RD affected ERM formation or staging.
Results :
Overall, 38% (21/54) cases were macula on detachments and 62% (34/54) were macula involving retinal detachments. 90% (49/55) of ERMs were diagnosed between 1 to 3 months post RD.
When MP was completed within 6 months of RD surgery (N=37), the final logMAR visual acuity (VA) was 0.3 (20/40). If the MP was completed after 6 months (N=17) , the logMAR VA was 0.65 (20/80). This was statistically significant with a p value of 0.005. Of the patients who had MP after 6 months, 59% (10/17) underwent cataract surgery between the RD repair and MP. The other 7 patients were pseudophakic at the time of the RD.
67% (36/54) of ERMs where graded to be stage 4 while 24% (13/54) where found to be stage 3. The remaining 11% (6/54) were stage 2. The logMAR final VA of stage 4 ERMs was 0.43 (20/50-), stage 3 was 0.38 (20/40-) and stage 2 was 0.30 (20/40). There was no significant difference in final VA or macular status between the stages.
Conclusions :
In this study, ERMs formed after RD were most likely be stage 4, which did not impact the final VA. There was a statistically significant difference in final VA between patient who underwent MP less than 6 months compared to those who delayed more than 6 months. This is relevant if the retinal surgeon delays MP until the cataract has been removed.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.