Epiretinal Membrane Surgery after Retinal Detachment Repair: Visual Acuity Outcomes and OCT Analysis
Soares RR, Mahmoudzadeh R, Salabati M, Massenzio E, Israilevich R, Patel SN, Hinkle J, Kuriyan AE, Hsu J, Garg SJ, Khan MA. Epiretinal Membrane Surgery after Retinal Detachment Repair: Visual Acuity Outcomes and OCT Analysis. Ophthalmol Retina. 2021 Mar 29:S2468-6530(21)00103-2.
Epiretinal membrane (ERM) formation commonly occurs after primary rhegmatogenous retinal detachment (RD) repair with a variable incidence of 6.1 to 12.8%. It is thought to be secondary to the release of retinal pigment epithelium (RPE) cells from the retinal break and subsequent proliferation on the retinal surface. The disruption of the retinal surface contour may result in decreased visual acuity or development of metamorphopsia. Studies on optical coherence tomography (OCT) features as predictors of VA outcomes in eyes with secondary ERM after RD repair are limited to date.
In this retrospective, consecutive case series, Soares et al identified 53 eyes of 53 patients that underwent membrane peeling (MP) with internal limiting membrane (ILM) removal after primary RD repair with pars plana vitrectomy with or without scleral buckle. VA improved from 20/200 to 20/56 six months after MP. Eyes with macula-on RD had better VA at 6 months (20/39). MP occurring 180 days from RD repair and IS/OS loss on OCT were associated with worse visual outcomes. In addition, RD repair with PPV/SB prior to MP was associated with worse VA at 6 months after MP.
In summary, eyes undergoing MP after RD repair had improved VA overall regardless of ERM stage and macula status at time of RD. However, eyes with IS/OS disruption pre-MP were associated with worse VA outcomes after MP, compared to eyes without this finding on OCT.