Proportion and risk factors of epiretinal membrane in residents of Brussels with versus without diabetes mellitus.

PURPOSE: To compare the proportion of epiretinal membrane (ERM) between individuals with diabetes mellitus (DM) and without DM, who live in Brussels, to investigate possible risk factors for ERM formation and to compare the results with the ones of large population studies. METHODS: Participants were divided into two groups; 99 patients with DM (group A) and 103 individuals without DM (group B). All participants underwent an undilated 7-field color fundus photography and a spectral domain optical coherence tomography (SD-OCT). Age, gender, race, type of diabetes, duration of medical treatment of diabetes, HbA1C rate, smoking, previous cataract surgery and educational level were investigated as possible risk factors. RESULTS: Epiretinal membrane was detected in 17.2% of group A and in 11.7% of group B participants. The difference is not statistically significant (χ2 (1) = 1.252, p = 0.263). The proportion of ERM was significantly associated with age in both groups (p = .009 and p < .001 respectively), as well as with smoking (p = .023) and previous cataract surgery (p = .028) in patients with DM. CONCLUSION: There is no statistically significant difference of ERM proportion between the two groups of the study. Age was recognized as a risk factor for both groups, while smoking and previous cataract surgery were identified as predictors only for diabetics.

Prevalence, Concordance, and Heritability of Vitreomacular Interface Abnormalities in a Twin Study.

Purpose: The relative importance of genetic factors in common vitreomacular interface (VMI) abnormalities is unknown. The aim of this classical twin study is to determine the prevalence case wise concordance between monozygotic and dizygotic twin pairs, and heritability of common VMI abnormalities, including epiretinal membrane (ERM), posterior vitreous detachment (PVD), vitreomacular adhesion (VMA), vitreomacular traction (VMT), lamellar macular holes (LMHs), and full-thickness macular holes (FTMHs). Methods: This is a single-center, cross-sectional classical twin study of 3406 TwinsUK participants over the age of 40 years who underwent spectral domain macular optical coherence tomography (SD-OCT) scans which were graded for signs of VMI abnormalities. Case wise concordance was calculated and the heritability of each VMI abnormality was estimated using OpenMx structural equation modeling. Results: In this population (mean age = 62.0 years [SD = 10.4 years], range = 40-89 years) the overall prevalence of ERM was 15.6% (95% confidence interval [CI] = 14.4-16.9) and increased with age, posterior vitreous detachment affected 21.3% (20.0-22.7), and VMA was diagnosed in 11.8% (10.8-13.0). Monozygotic twins were more concordant for all traits than dizygotic twins, and age, spherical equivalent refraction (SER), and lens status-adjusted heritability was estimated at 38.9% (95% CI = 33.6-52.8) for ERM, 53.2% (95% CI = 41.8-63.2) for PVD, and 48.1% (95% CI = 33.6-58) for VMA. Conclusions: Common VMI abnormalities are heritable and therefore have an underlying genetic component. Given the sight-threatening potential of VMI abnormalities, further genetic studies, such as genomewide association studies, would be useful to identify genes and pathways implicated in their pathogenesis.

LONG-TERM PROGRESSION PATTERN OF MYOPIC TRACTIONAL MACULOPATHY: Outcomes and Risk Factors.

PURPOSE: To evaluate the long-term progression pattern of myopic tractional maculopathy and the risk factors. METHODS: The prevalence and grade of myopic tractional maculopathy were assessed with optical coherence tomography at enrollment and at the 2-year follow-up. The severity of posterior staphyloma and the presence of dome-shaped macula were also evaluated. RESULTS: In total, 610 highly myopic eyes of 610 patients were analyzed. The prevalence of epiretinal membrane, myopic retinoschisis, and macular hole increased from 26.7%, 12.1%, and 4.4% at enrollment to 41.1%, 18.2%, and 9.5% at the 2-year follow-up, respectively. Epiretinal membrane progressed in 21.8% of eyes, but visual acuity did not decline significantly in these eyes. Myopic retinoschisis progressed in 6.8% of eyes, and macular hole progressed in 14.8% of eyes. Significantly greater best-corrected visual acuity reduction was detected in the eyes with myopic retinoschisis or macular hole progression than the rest ( P < 0.05). Multivariate analysis showed that longer axial length, more-severe posterior staphyloma, and absence of dome-shaped macula were associated with myopic tractional maculopathy progression. CONCLUSION: In highly myopic eyes, long-term visual acuity was relatively stable in those with epiretinal membrane, but was significantly affected by myopic retinoschisis or macular hole progression. Longer axial length, more-severe posterior staphyloma, and absence of dome-shaped macula were risk factors for myopic tractional maculopathy progression.

Large Internal Limiting Membrane Tears: Prevalence, Clinical Characteristics, and Surgical Utility.

PURPOSE: To describe the prevalence, clinical and imaging characteristics, and surgical utility of large internal limiting membrane (ILM) tears in eyes with epiretinal membrane (ERM). DESIGN: Retrospective interventional case series. METHODS: This was a single-institution study including 71 eyes of 70 consecutive patients that underwent ERM peeling by a single vitreoretinal surgeon between 2016 and 2019. Demographic and clinical data were collected from the medical record. ERMs and large ILM tears were identified and analyzed on multimodal imaging. The main outcome measures were the prevalence and characteristics of large ILM tears in eyes undergoing ERM peeling. RESULTS: Large ILM tears were present in 23 of 71 eyes (32.4%) with ERM that underwent surgical management. A review of patients with ERM during the same period who did not undergo surgical management found large ILM tears in 8 of 100 eyes (8.0%). Large ILM tears were commonly associated with other signs of ERM-induced retinal traction, including retinal nerve fiber layer schisis in 20 of 23 eyes (87.0%), inner retinal dimpling in 8 of 23 eyes (34.8%), and discrete paravascular red lesions in 16 of 19 eyes (84.2%). In all eyes stained with brilliant blue G, the preoperative diagnosis of large ILM tear was confirmed and the scrolled ILM edge was used successfully to initiate ILM peeling. CONCLUSIONS: Large ILM tears are often present in eyes undergoing surgery for ERM and are likely caused by ERM contracture. Careful preoperative identification of these tears is helpful for surgical planning because the scrolled flap of ILM provides a convenient and safe "handle" for initiating membrane peeling.

Prevalence and risk factors of epiretinal membrane: Data from the Korea National Health and Nutrition Examination Survey VII (2017-2018).

BACKGROUND: To determine the prevalence and risk factors of epiretinal membrane (ERM) utilising spectral-domain optical coherence tomography (SD-OCT). METHODS: We investigated data from the 2017 to 2018 Korea National Health and Nutrition Examination Survey. Individuals aged ≥40 years with readable fundus photographs and SD-OCT results were included. ERM was diagnosed by fundus photography and OCT. The following data was collected: demographics, health interview, health examination, and nutritional survey results. The prevalence of ERM was estimated and risk factors for ERM were analysed. RESULTS: A total of 6807 participants were finally included. Adjusted prevalence of ERM was 7.0% (95% confidence interval, 6.3%-7.8%). Multivariate logistic regression analysis revealed that age ≥ 50 years (p < 0.001 for all age groups), history of cataract surgery (p < 0.001), well-controlled hypertension (p = 0.006), and diabetic retinopathy (p = 0.041) were risk factors for ERM. CONCLUSIONS: The estimated prevalence of ERM was 7.0%, which was higher than that of previous reports using fundus photography only in an East Asian population. Possible risk factors for ERM were older age, history of cataract surgery, hypertension, and diabetic retinopathy.

Incidence and onset time of epiretinal membranes after two retinopexy techniques.

OBJECTIVE: To compare the incidence and onset time of epiretinal membranes after two surgical techniques to treat retinal detachment (retinopexy). METHOD: Non-experimental, retrospective, longitudinal and comparative study in patients treated of primary rhegmatogenous retinal detachment either with cryotherapy and scleral buckle (group 1) or vitrectomy techniques (group 2), without an epiretinal membrane at the moment of surgery. We compared the incidence of postoperative epiretinal membrane between groups, the median onset time (Mann-Whitney's U) and the proportions of eyes without an epiretinal membrane along time with a survival analysis (log-rank). RESULTS: 112 eyes in group 1, 48 in group 2; the incidence of epiretinal membrane was 23.2% in group 1 and 20.8% in group 2 (p = 0.8). The median time of onset was 12 weeks in group 1 (interquartile rank 8.75-16) and 18 in group 2 (12.5-22, p = 0.02). The log-rank test showed no differences of incidence along the follow-up between groups (p = 0.6). CONCLUSIONS: Epiretinal membranes appear early after retinopexy, before in eyes treated with crio-retinopexy. Although their incidence does not differ between groups, detecting them could start two months after a scleral buckle and three after a vitrectomy procedure.

OBJETIVO: Comparar la incidencia y el tiempo en que aparecen las membranas epirretinianas después de dos técnicas quirúrgicas para tratar el desprendimiento de retina (retinopexia). MÉTODO: Estudio observacional, retrospectivo, longitudinal y comparativo en pacientes operados por desprendimiento regmatógeno primario de retina sin una membrana epirretiniana al momento de la cirugía, divididos en grupos: operados mediante criorretinopexia/cerclaje escleral (grupo 1) o vitrectomía (grupo 2). Se compararon entre grupos la incidencia de membrana epirretiniana, la mediana del tiempo de aparición (U de Mann-Whitney) y las proporciones de ojos sin membrana epirretiniana temporalmente mediante un análisis de sobrevida (log-rank). RESULTADOS: En 112 ojos en el grupo 1 y 48 ojos en el grupo 2, la incidencia de membrana epirretiniana fue del 23.2% en el grupo 1 y del 20.8% en el grupo 2 (p = 0.8). La mediana del tiempo de aparición fue de 12 semanas en el grupo 1 (rango intercuartílico [RIC]: 8.75-16) y de 18 semanas en el grupo 2 (RIC: 12.5-22; p = 0.02). La prueba de log-rank no mostró diferencias en la incidencia durante el seguimiento (p = 0.6). CONCLUSIONES: Las membranas epirretinianas se presentan tempranamente después de una retinopexia, antes en ojos operados mediante criorretinopexia. De acuerdo con la incidencia observada, su búsqueda podría empezar 2 meses después de un cerclaje y 3 meses después de una vitrectomía.

Incidence of Rhegmatogenous Retinal Detachment Following Macular Surgery in France Between 2006 and 2016.

PURPOSE: To report the incidence of postoperative rhegmatogenous retinal detachment after macular surgery in France between 2006 and 2016, and identify associated factors. DESIGN: Nationwide, population-based, cohort study. METHODS: All surgical procedures for an epiretinal membrane or a macular hole performed in France from January 1, 2006 to October 31, 2016 were identified in the French national administrative database (Programme de Médicalisation des Systèmes d'Information). The incidence of rhegmatogenous retinal detachment occurring within 90 days of a macular surgical procedure was investigated. RESULTS: From January 1, 2006 to October 31, 2016, 152,034 macular surgical procedures for epiretinal membranes or macular holes were recorded in France. Of these, 3605 cases of rhegmatogenous retinal detachment occurring within 90 days of the procedure were found. The incidence of rhegmatogenous retinal detachment was 2.37% overall, 1.95% for epiretinal membrane surgery, and 3.43% for macular hole surgery. In multivariable Poisson regression analysis, rhegmatogenous retinal detachment was associated with macular hole surgery (incidence rate ratio [IRR], 1.76; 95% CI, 1.63-1.90; P < .001), history of cataract extraction in the previous year (IRR, 1.20; 95% CI, 1.08-1.34; P = .001), age <60 years (P < .001), and male sex (IRR, 1.63; 95% CI, 1.51-1.76; P < .001). CONCLUSIONS: The incidence of rhegmatogenous retinal detachment within 90 days of macular surgery was 2.37% overall in France between 2006 and 2016, and it was higher for macular hole surgery than for epiretinal membrane surgery.

The Correlations of Macular Structure Characteristics With Idiopathic Epiretinal Membrane and Its Sexual Preference-A Matched Comparison Study.

Purpose: To measure the anatomical characteristics of the macula in fellow eyes of patients with unilateral idiopathic epiretinal membrane (ERM) and to compare them with normal controls. Methods: A total of 83 fellow eyes with unilateral idiopathic ERM were gathered as the study group, and their age- and sex-matched subjects with no vitreomacular diseases were recruited as the control group. Macular structure parameters including foveal base width (FBW), central foveolar thickness (CFT), central subfield thickness (CST), area of foveal avascular zone (FAZ), and retinal artery trajectory (RAT) were measured using optical coherence tomography (OCT) and OCT angiography and were compared between two groups. Results: For the study group, the FBW (463.8 ± 79.6 µm) and area of FAZ (0.39 ± 0.12 mm2) were significantly larger than those in the control group (334.3 ± 76.5 µm, 0.31 ± 0.13 mm2). Their CST was thinner and their RAT was wider than those of the control group (P < 0.05 for all). In the normal population, females had a wider FBW, a thinner CFT, and a wider RAT than males (P < 0.05 for all). Conclusions: Fellow eyes of the unilateral ERM had a larger FBW, a larger FAZ, a thinner CST, and a wider RAT than the normal population. This implicates that some centrifugal tractional force may exist on their macula, which eventually may result in the formation of idiopathic ERM. Females had a wider FBW, a thinner CFT, and a wider RAT than males, which may explain the higher prevalence of idiopathic ERM in females.

Incidence and risk factors for macular oedema after primary rhegmatogenous retinal detachment surgery: a prospective single-centre study.

PURPOSE: To assess the incidence of cystoid macular oedema (CME) diagnosed by spectral domain optical coherence tomography (SD-OCT) after primary rhegmatogenous retinal detachment (RRD) surgery. METHODS: From April 2016 to October 2017, 150 eyes of 150 patients presenting with primary RRD were included consecutively in this prospective single-centre study. Patients with the following characteristics were excluded: previous vitreoretinal surgery, combined cataract surgery, preoperatively presentation with any intraocular or systemic inflammatory condition, visible macular oedema or epiretinal membrane (ERM) on funduscopy. SD-OCT (Spectralis, Heidelberg Engineering) was conducted 3 and 6 weeks after surgery. RESULTS: One hundred and twenty-eight of the 150 patients completed the study, of whom 107 (age: 61.7 ± 11.5 years, mean ± SD) showed successful retinal attachment during follow-up visits. The most frequent operation method was scleral buckling (54.2%), followed by vitrectomy (25.2%) and the combination of both techniques (20.6%). Postoperative SD-OCT revealed CME, neurosensory detachment and ERM in 18.7, 31.8 and 32.7% of all cases, respectively. The risk of postoperative CME was significantly elevated in patients with ERM (42.9 versus 6.9%, p < 0.001). In addition, patients with initial detachment of the macula had more postoperative CME (26.5 versus 11.1%, p = 0.044). BCVA improvement was significantly lower in patients with CME compared to patients without 6 weeks after surgery for macula-on RRD. CONCLUSIONS: This prospective study confirmed that postoperative CME is a frequent complication after RRD surgery; we identified ERM and macula-off RRD as potential risk factors. As CME potentially delays visual recovery, postoperative follow-ups should include SD-OCT.

ASSOCIATION BETWEEN EPIRETINAL MEMBRANE, EPIRETINAL PROLIFERATION, AND PROGNOSIS OF FULL-THICKNESS MACULAR HOLE CLOSURE.

PURPOSE: To demonstrate the effects of epiretinal membrane (ERM) and epiretinal proliferation on surgical outcomes for full-thickness macular hole. METHODS: Nested case-control study with propensity score matching. Patients operated on for full-thickness macular hole between January 2011 and March 2020 were enrolled. The primary outcome was failure of the macular hole closure, and the secondary outcome was unfavorable hole closure (V or λ type closure) at 6 months after the surgery. RESULTS: Five hundred and thirty-four eyes of 534 patients met the inclusion criteria. After 1:1 propensity score matching (127 pairs), patients demonstrating ERM were more likely to have a failure of hole closure (adjusted odds ratio, 2.71; 95% confidence interval, 1.19-6.14) and unfavorable hole closure (adjusted odds ratio, 2.07; 95% confidence interval, 1.16-3.71). Epiretinal membrane spanning the hole margin (hole marginal ERM) greatly increased the likelihood of unfavorable hole closure (adjusted odds ratio, 2.13; 95% confidence interval, 1.12-4.07). Patients with hole marginal-ERM + epiretinal proliferation were more likely to have a failure of hole closure (38.4%) compared with those with no ERM (11.8%). CONCLUSION: Patients with ERM had a higher risk for adverse surgical outcomes for full-thickness macular hole closure. The location of the ERM relative to the macular hole and the presence of epiretinal proliferation might affect the surgical outcomes for full-thickness macular hole closure.

Visual outcomes and incidence of pseudophakic cystoid macular oedema in eyes with cataract and idiopathic epiretinal membrane after two-step sequential surgery.

OBJECTIVES: To determine whether pars plana vitrectomy (PPV) or cataract surgery should be performed first in concurrent epiretinal membrane (ERM) and cataract treatment with respect to visual outcome and pseudophakic cystoid macular oedema (PCMO) incidence. METHODS: Patients who underwent PPV and cataract surgery sequentially at a tertiary medical centre were retrospectively recruited. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) measured from optical coherence tomography (OCT) images collected before and after each surgery were documented. OCT-defined PCMO incidence and its influence on visual outcomes were analysed. RESULTS: In total, 259 and 159 eyes received PPV (ERM-CATA) before and after cataract surgery (CATA-ERM), respectively. The ERM-CATA group had better final BCVA (logMAR: 0.274 vs. 0.558, p < 0.001) and greater BCVA gain (logMAR VA change: -0.379 vs. -0.220, p = 0.001) than did the CATA-ERM group. Baseline BCVA was positively correlated with final BCVA (p < 0.001), whereas baseline CMT, final CMT, and postoperative CMT changes were not. PCMO incidence did not differ significantly between the two groups (15.4% vs. 19.5%, p = 0.287), and final BCVA changes did not significantly differ between eyes with and without PCMO. PCMO incidence was much higher (29.40% vs. 16.30%, p = 0.008) in eyes with baseline CMT ≥ 500 µm. CONCLUSIONS: When managing ERM and cataract, PPV should be performed before cataract surgery to yield better visual outcomes. Both surgical sequences yield similar PCMO rates. Greater baseline CMT is a risk factor for PCMO after cataract surgery.

Foveal microstructure and visual function in patients with lamellar macular hole, epiretinal membrane foveoschisis or macular pseudohole.

PURPOSE: To compare the foveal microstructures, such as the prevalence of epiretinal proliferation (EP) and residual ellipsoid zone (EZ), in eyes with lamellar macular hole (LMH), epiretinal retinal membrane (ERM) foveoschisis and macular pseudohole (MPH), and to investigate the association of the foveal microstructure with visual functions. METHOD: In addition to the prevalence of EP, we calculated the residual EZ index within 1mm and 3 mm (rEZ1 and rEZ3) in all examined eyes. Comparisons were conducted to baseline characteristics (logMAR visual acuity [logMAR VA], metamorphopsia score [Mave], central retinal thickness [CRT], the prevalence of EP, rEZ1 and rEZ3) between MPH, ERM foveoschisis and LMH subgroups. The relationships (1) between logMAR VA and each of age, type (MPH, ERM foveoschisis and LMH), the prevalence of EP, rEZ1, rEZ3, spherical equivalent (SE) and CRT and (2) between Mave and each of variables were investigated. RESULTS: Fifty-one eyes of 48 patients were enroled. The mean age was 65.2 ± 11.1 years. Ten eyes were diagnosed as LMH, 22 eyes as ERM foveoschisis and 19 eyes as MPH, respectively. There was a significant difference in CRT only between LMH and ERM foveoschisis (p = 0.023). There was a tendency toward significance in rEZ1 between LMH and ERM foveoschisis (p = 0.057), but not in rEZ3. The optimal model for logMAR VA included age, rEZ1, SE and CRT. On the other hand, the optimal model for Mave included the prevalence of EP, rEZ1 and SE. CONCLUSION: Microstructural observations are useful to predict visual functions in LMH, ERM foveoshisis and MPH.

The development of epiretinal membrane following rhegmatogenous retinal detachment repair: incidence, risk factors, and outcomes.

PURPOSE: To investigate the incidence, risk factors, and visual outcomes of epiretinal membrane development following rhegmatogenous retinal detachment repair. METHODS: This was a retrospective study of 309 eyes that underwent initial surgery for primary uncomplicated rhegmatogenous retinal detachment. Examinations were conducted preoperatively and then postoperatively at 1, 3, 6, and 12 months. The study patients were categorized into two groups depending on the presence or absence of the epiretinal membrane. RESULTS: The incidence of postoperative epiretinal membrane was 28.5%; 42.7% of these patients had severe epiretinal membrane development and therefore underwent the epiretinal membrane removal. Logistic regression analyses revealed that giant retinal tears (OR: 2.66; 95% CI: 1.045-6.792, p=0.040) and horseshoe tears (OR: 0.534; 95% CI: 0.295-0.967, p=0.039) were the significant predictors of postoperative epiretinal membrane. Triamcinolone acetonide staining was significantly associated with the prevention of epiretinal membrane (p=0.022). A total of 34 patients showed a better or an equal final best-corrected visual acuity; of which 4 eyes were evaluated at the final follow-up visit and exhibited a reduced best-corrected visual acuity. CONCLUSION: Our analysis demonstrated that horseshoe tears and giant retinal tears represent the risk factors for the postoperative epiretinal membrane. Triamcinolone acetonide staining had a significant preventive effect on the postoperative epiretinal membrane. Furthermore, a second round of pars plana vitrectomy, including membrane removal, led to a significant improvement in the final best-corrected visual acuity as per the last follow-up examination, albeit the recovery was limited.

Comparison of the Prevalence and Clinical Characteristics of Epiretinal Membrane in Pseudoexfoliation and Primary Open-angle Glaucoma.

PURPOSE: The purpose of this study was to investigate and compare the prevalence and clinical characteristics of epiretinal membrane (ERM) in patients with pseudoexfoliation glaucoma (PXG) and primary open-angle glaucoma (POAG). METHODS: In this retrospective observational study, 211 PXG eyes, 210 age-matched normal eyes, and 220 POAG eyes were included. The presence and staging of ERM (stage 1, 2, and 3 or greater) were independently assessed by 2 observers. Univariate and multivariate linear regression analyses were performed to assess the factors associated with visual field (VF) mean deviation (MD) in PXG eyes. RESULTS: Among 211 PXG eyes, 40 (19.0%) had an ERM, while 4.1% of POAG and 2.4% of normal eyes had an ERM (P<0.001). Retinal nerve fiber layer thickness (69.4 vs. 70.4 µm, P=0.477) and VF MD (-7.7 vs. -10.4 dB, P=0.098) were not different between POAG and PXG eyes but macular thickness was greater (259.5 vs. 271.5 µm, P=0.006) in PXG eyes than in POAG. Both lower retinal nerve fiber layer thickness (ß=0.337, P<0.001) and the presence of an ERM (ß=-4.246, P=0.002) were independently associated with worse VF MD in PXG eyes. CONCLUSIONS: The prevalence of ERM was significantly greater in PXG eyes than in age-matched normal or POAG eyes. The presence of ERM affected VF in PXG eyes.

Prevalence of epiretinal membrane in the phakic eyes based on spectral-domain optical coherence tomography.

The prevalence of epiretinal membrane (ERM) and associated factors in the phakic eyes have not been fully elucidated yet. This cross-sectional study included 2,354 phakic eyes without retinal diseases or surgical history. Ocular parameters, such as uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), intraocular pressure (IOP), white-to-white corneal diameter (WTW), mean keratometric value (Km) of total corneal refractive power at 4-mm diameter (TCRP4), astigmatism of TCRP4, total corneal irregular astigmatism (TCIA), pupil diameter, axial length (AXL), anterior chamber depth (ACD), lens thickness (LT), and posterior vitreous detachment (PVD) were compared between ERM group and control group. Additionally, an age-matched control group was selected by individual matching and compared with the ERM group to eliminate the confounders. Multiple logistic regression analysis was performed to evaluate the factors associated with the presence of ERM. Among 2,354 eyes, 429 eyes (18.2%) had ERM based on spectral-domain optical coherence tomography. The ERM group showed higher prevalence of PVD, worse CDVA, higher astigmatism of TCRP4, higher TCIA, smaller pupil size, longer AXL, and thicker LT than control group (P < 0.001, P < 0.001, P = 0.011, P < 0.001, P = 0.023, P < 0.001, and P < 0.001, respectively). Only PVD, CDVA, SE, astigmatism of TCRP4, TCIA, and AXL maintained the significance when compared with the age-matched control group (P < 0.001, P = 0.026, P < 0.001, P = 0.001, P = 0.003, and P < 0.001, respectively). Multivariate logistic regression analysis showed that age, PVD, CDVA, and TCIA were independently associated with the presence of ERM (P < 0.001, P < 0.001, P = 0.011, and P = 0.002). The prevalence of ERM detected using SD-OCT was 18.2% in the middle aged phakic population. Eyes with TCIA, in addition to older age and PVD, were more likely to have ERM.

Effect of Foveal Vitreous Cortex Removal to Prevent Epiretinal Membrane after Vitrectomy for Rhegmatogenous Retinal Detachment.

PURPOSE: To determine the effect of foveal vitreous cortex removal during pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) on the prevention of postoperative epiretinal membrane (ERM) development without internal limiting membrane (ILM) peeling. DESIGN: Case-control study. PARTICIPANTS: A total of 105 consecutive eyes of 105 patients who underwent primary PPV for RRD between September 2018 and August 2019 and were followed for at least 6 months. METHODS: The presence of foveal vitreous cortex during PPV was determined by examining the images obtained by a widefield viewing system in 52 eyes (WF group) operated in the first half of the study period and obtained by a high-magnification floating lens in 53 eyes (FL group) operated in the latter half of the study period. Triamcinolone acetonide was used to make the vitreous cortex more visible during PPV. The foveal vitreous cortex was removed if detected by forceps with a high-magnification floating lens without ILM peeling or use of dye staining. The presence of postoperative ERM was examined by using OCT. MAIN OUTCOME MEASURES: The rate of detected and removed foveal vitreous cortex during PPV and the incidence of postoperative ERM of each group. RESULTS: The rate of detected and removed foveal vitreous cortex during PPV was significantly higher in the FL group than in the WF group (41.5% vs. 15.4%, P = 0.004). The incidence of postoperative ERM was significantly lower in the FL group than in the WF group (1.9% vs. 13.5%, P = 0.03). None of the eyes required additional surgery for the postoperative ERM during the follow-up period. The retinal reattachment rate was not significantly different (98.1% vs. 100%, P = 0.99), and the final retinal attachment rate was 100% in both groups. A dissociated optic nerve fiber layer appearance and a temporal macular thinning were not detected postoperatively in any of the eyes with removal of the foveal vitreous cortex during PPV. CONCLUSIONS: The detection and removal of foveal vitreous cortex with the high-magnification floating lens during PPV for RRD significantly reduce the incidence of postoperative ERM without adverse findings.

INCIDENCE, PROGRESSION, AND RISK FACTORS OF EPIRETINAL MEMBRANES IN THE ELDERLY.

PURPOSE: To determine the incidence, progression rate, and risk factors for epiretinal membranes (ERMs) in a population of French elderly subjects. METHODS: Seven hundred and thirty-five eyes of 413 participants of the population-based ALIENOR study were included between 2009 and 2010. Participants were re-evaluated every 2 years between 2011 and 2017 (i.e., three follow-up visits). The mean duration of follow-up was 5.09 years (SD, 1.8; range, 0.99-7.85). Epiretinal membranes were graded from spectral-domain optical coherence tomography images according to a standardized classification. RESULTS: The incidence rate of ERMs was 9.42 per 100 eye-years (95% confidence interval, 7.36-12.05), corresponding to a 5-year cumulative incidence of 37.6%. In the final multivariable model, ERM incidence was significantly associated with vitreomacular or vitreopapillary adhesion at baseline (hazard ratio, 2.15; P = 0.02), choroidal thinning (hazard ratio, 1.04 per 10 µm decrease; P = 0.02), ERM in the contralateral eye (P = 0.02), and smoking after 85 years (hazard ratio, 6.01; P = 0.003). The 5-year cumulative progression rate was 6.9%. CONCLUSION: Incidence of ERMs was higher in our population than that previously reported, most probably because of the use of spectral-domain optical coherence tomography images. Incident ERMs were found to be associated with vitreous adhesion at baseline, choroidal thinning, ERM in the contralateral eye, and smoking after 85 years.

RECURRENCE OF IDIOPATHIC EPIRETINAL MEMBRANE AND ITS PREDISPOSING FACTORS: An Optical Coherence Tomography Study.

PURPOSE: To evaluate the incidence and clinical course of recurrent epiretinal membrane (ERM) after ERM surgery and to identify predisposing optical coherence tomography (OCT) findings for the recurrence. METHODS: Postoperative ERM recurrence, defined as reappearance of the membrane after its removal or regrowth of the remnant membrane, was investigated in 301 eyes with idiopathic ERM followed up for more than 6 months after macular surgery by fundus photographs and spectral-domain OCT. The incidences of recurrent ERM and its associated clinical characteristics were assessed. Preceding OCT findings in the area subsequently showing recurrent ERM were evaluated at early postoperative periods. RESULTS: Among the 301 eyes that underwent ERM peeling, 119 (39.5%) and 86 (28.6%) showed ERM recurrence on OCT images and biomicroscopic examination/fundus photographs, respectively, during the follow-up period (average: 18.1 months). Neighboring remnant membrane and hyperreflective dots on the retinal surface at 1 week after the surgery and postoperative inner retinal wrinkling persisting for ≥1 month were predisposing OCT findings for ERM recurrence, with an odds ratio of 6.48 (95% confidence interval, 3.51-12.0), 3.48 (95% confidence interval, 1.81-6.70), and 6.11 (95% confidence interval, 3.30-11.3), respectively (all P < 0.001). CONCLUSION: Incidence of ERM recurrence varies depending on the definition used for the recurrence. Optical coherence tomography examination may be useful for the prediction and sensitive detection of recurrent ERM.

Prevalence and Risk Factors of Epiretinal Membranes in a Chinese Population: The Kailuan Eye Study.

Purpose: To investigate the prevalence of epiretinal membranes (ERMs) and their risk factors in a Chinese population. Methods: The community-based Kailuan Eye Study included 14,440 participants (9835 male, 4605 female) with a mean age of 54.0 ± 13.3 years (range, 20-110 years). They underwent a systemic and ophthalmologic examination. ERMs were diagnosed on fundus photographs. Results: Retinal photographs assessable for the presence of ERMs were available for 13,295 (92.0%) individuals (9094 male) with a mean age of 53.6 ± 13.3 years (range, 20-110 years). ERMs were found in 1013 participants (1489 eyes) with a prevalence of 7.6% (95% confidence interval [CI], 7.1%-8.1%). Secondary ERMs caused by intraocular reasons were found 46 (4.5%) individuals (69 [4.6%] eyes). A higher prevalence of any ERMs (and of primary ERMs) was associated with older age (odds ratio [OR]: 1.08; 95% CI:1.07-1.10), higher body mass index (OR: 1.05; 95% CI: 1.00-1.11), higher prevalence of smoking (OR:1.43; 95% CI: 1.01-2.03), higher serum concentration of glucose (OR: 1.08; 95% CI: 1.04-1.13), and lower serum concentration of uric acid (OR: 0.99; 95% CI: 0.99-1.00). Visual acuity was significantly (P = 0.002) lower in eyes with premacular fibroses than in eyes with cellophane macular reflexes. Conclusions: In our cross-sectional community-based study, the prevalence of all ERMs was 7.6%. Among the group of participants with ERMs, secondary ERMs caused by intraocular reasons were detected in 46 (4.5%) individuals (69 [4.6%] eyes). A higher prevalence of any ERM and of primary ERMs was associated with older age, higher body mass index, higher prevalence of smoking, a higher serum concentration of glucose, and a lower serum concentration of uric acid.