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  • Vitreous hemorrhage tied to increased risk of epiretinal membrane

    Retina/Vitreous

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    Review of: Risk Factors, Onset, and Progression of Epiretinal Membrane after 25-Gauge Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

    Ishida Y, Iwama Y, Nakashima H, et al. Ophthalmology Retina, March 2020

    This retrospective, comparative case series examined risk factors, onset timing and progression of epiretinal membrane after pars plana vitrectomy for rhegmatogenous retinal detachment (RRD).

    Study design

    The study included 322 eyes that underwent primary vitrectomy for RRD during a 3-year period. Cases with ERM had hyperreflective lines above the inner retinal surface and deformation of the foveal pit. Patients were assessed before and at 1, 3, 6 and 12 months after surgery. The authors used a multivariate logistic regression model to identify ERM risk factors and used OCT findings to assess ERM onset timing and progression.

    Outcomes

    Incidence of postoperative ERM was higher in eyes with preoperative vitreous hemorrhage (P=0.011) and eyes that did not undergo internal limiting membrane (ILM) peeling (P<0.001). The authors note that none of the patients who underwent ILM peeling demonstrated postoperative ERM. Thirty-nine eyes had postoperative ERM within 1 year; 77% of these cases occurred as early as 3 months. Among the 12 eyes with advanced ERM, 9 showed progression by postoperative month 3.

    Limitations

    This study was limited by its retrospective study design. Surgical procedures were performed without predefined criteria.

    Clinical significance

    Preoperative vitreous hemorrhage was linked to an increased occurrence of postoperative epiretinal membrane progression. Since the occurrence and progression of epiretinal membrane were often detected soon after surgery, high-risk patients should be carefully followed for at least 3 months.