Abstract
Purpose :
Epiretinal membrane (ERM) and macular hole (MH) formation are known and treatable complications of rhegmatogenous retinal detachment (RRD) repairs. The purpose of this study is to use a large database to better assess the risk for development of ERM and MH after RRD repair. To the best of our knowledge, this has only been studied in the past using relatively small cohorts.
Methods :
A retrospective cohort study was performed using the de-identified Vestrum Health Database. Patients who underwent RRD repair between January 2015 and October 2023 who had at least 3 months of follow-up were included in the study. Eyes with proliferative vitreoretinopathy, preexisting ERM, or preexisting MH at time of RRD diagnosis were excluded. Among these patients, MH and ERM were identified following RRD repair.
Results :
66302 eyes who initially had a primary RRD repair were identified. Mean age was 61 years old and 64% were male. 52% of the RRDs were in the right eye. 28885 eyes (44%) were phakic at RRD diagnosis. 1742 eyes (3%) developed a MH with or without ERM post-repair. Median time to MH diagnosis was 154 days post-repair. Mean visual acuity (VA) at MH diagnosis was 37.57 ETDRS letter score (~20/180). Of those that developed a MH, 791 eyes (45%) underwent pars plana vitrectomy (PPV) with membrane peel (MP) with a median time of 16 days from diagnosis. 19377 eyes (29%) developed only an ERM without a concomitant MH. Median time to ERM diagnosis was 128 days post-repair. Mean VA at ERM diagnosis was 58.61 ETDRS letter score (~20/70). Of those that developed only an ERM, 3231 eyes (17%) underwent PPV+MP with a median time of 107 days from diagnosis. 21119 eyes (32%) developed a MH and/or ERM. Median time to MH/ERM diagnosis was 125 days post-repair. Mean VA at MH/ERM diagnosis was 57.00 ETDRS letter score (~20/70-). Of those that developed a MH and/or ERM, 4022 eyes (19%) underwent PPV+MP with a median time of 95 days from diagnosis.
Conclusions :
MHs were rarer with a 3% incidence rate compared to 29% for ERM only after RRD repair. PPV+MP was done much quicker for cases of MH compared to those with ERM only. Further investigation using this dataset to assess the association of RRD macular status with MH/ERM formation, MH/ERM characteristics stratified by initial VA at RRD diagnosis, and visual outcomes after MP is underway.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.