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. The patient’s VA improved from 20/200 to 20/56 within 6 months after MP. Eyes with macula-on RD had better VA at 6 months (20/39). MP occurring 180 days or less from RD repair and inner segment/outer segment (IS/OS) loss on OCT were associated with worse visual outcomes. In addition, RD repair with pars plana vitrectomy/ scleral buckle prior to MP was associated with worse VA at 6 months after MP.
In summary, eyes undergoing MP after RD repair had improved visual acuity overall, regardless of ERM stage and macula status at time of RD. However, eyes with IS/OS disruption pre-MP were associated with worse visual acuity outcomes after MP compared to eyes without this finding on OCT.
August 2021: VBS Literature Update
Soares RR, Mahmoudzadeh R, Salabati M, et al. Epiretinal membrane surgery after retinal detachment repair: Visual acuity outcomes and OCT analysis. Ophthalmol Retina. 2021:S2468-6530(21)00103-2.
Abstracted by Dan Su, MD
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Daniel Su, MD
Retina-Vitreous Associates Medical Group
Los Angeles, CA
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