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. 2021 Aug 4;8(1):29.
doi: 10.1186/s40662-021-00252-4.

Increased risk of postsurgical macular edema in high stage idiopathic epiretinal membranes

Lorenzo Iuliano  1 , Gloria Cisa di Gresy  2 , Giovanni Fogliato  2 , Eleonora Corbelli  2 , Francesco Bandello  2 , Marco Codenotti  2
Affiliations

Increased risk of postsurgical macular edema in high stage idiopathic epiretinal membranes

Lorenzo Iuliano et al. Eye Vis (Lond). .

Abstract

Purpose: To assess the rate of occurrence and the risk factors of postsurgical macular edema (PSME) in eyes with idiopathic epiretinal membrane (iERM) or full-thickness macular hole (FTMH).

Methods: Retrospective longitudinal analysis of all subjects scheduled for vitrectomy with or without combined cataract surgery over a 6-month period. Electronic medical charts and imaging data were analyzed preoperatively and at 1, 3 and 6 months after surgery.

Results: From 101 patients diagnosed with iERM or FTMH, 71 patients were eligible for the study. Forty-nine eyes with iERM (69.0%) and 22 eyes with FTMH (31.0%) underwent vitrectomy either isolated (31.0%) or combined with cataract extraction (69.0%). The overall rate of PSME was 26.7%, without differences between the two groups (P = 0.9479). Combined cataract extraction did not affect the overall occurrence of PSME rate in both groups (P = 0.9255 in FTMH and P = 0.8658 in iERM). If grouped by stage, eyes with stage 4 iERM though disclosed an increased rate of PSME (57.1%) compared to lower (1 to 3) stages (14.3%, P = 0.0021), particularly when combined with cataract surgery (71.4% vs. 15.4% in stages ≤ 3, P = 0.0021). The PSME odds ratio for a stage 4 iERM is 8 (95% CI: 1.933-33.1; P = 0.0041) compared to stages 3 and below.

Conclusions: PSME remains a clinically relevant and frequent event after surgery for iERM and FTMH. Patients with stage 4 iERM have an 8-fold higher likelihood of developing PSME in a 6-month postsurgical period compared to iERM in 1-3 stages, especially when combined with cataract extraction.

Keywords: Epiretinal membrane; Macular edema; Macular hole; Postsurgical macular edema; Vitrectomy.

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Conflict of interest statement

Lorenzo Iuliano, Giovanni Fogliato, Eleonora Corbelli, Gloria Cisa di Gresy, Marco Codenotti: None.

Francesco Bandello is a consultant for: Alcon (Fort Worth, Texas, USA), Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc. (Irvine, California, USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Shering-Pharma (Berlin, Germany), Bausch And Lomb (Rochester, New York, USA), Genentech (San Francisco, California, USA), Hoffmann-La-Roche (Basel, Switzerland), Novagali Pharma (Évry, France), Novartis (Basel, Switzerland), Sanofi-Aventis (Paris, France), Thrombogenics (Heverlee, Belgium), Zeiss (Dublin, USA).

Figures

Fig. 1
Fig. 1
Postsurgical macular edema after surgery for stage 3 idiopathic epiretinal membrane. Preoperative (a) 30° combined infrared reflectance and structural optical coherence tomography vertical B-scan passing through the fovea of a case of stage 3 idiopathic epiretinal membrane. Characteristic features are the ectopic inner foveal layer and the absence of the foveal depression. One month after surgery (b) cystoid macular edema is evident, with increased central foveal thickness
Fig. 2
Fig. 2
Rate of postsurgical macular edema according to the epiretinal membrane stage. Stage 4 idiopathic epiretinal membranes disclose higher rate of postsurgical macular edema compared to overall rate of less-than-4 stages
Fig. 3
Fig. 3
Cumulative frequency of postsurgical macular edema according to the epiretinal membrane stage. The cumulative frequency of postsurgical macular edema throughout the follow-up significantly reduced, with a reduction rate greater for stage 4 idiopathic epiretinal membranes with respect to stages 1–3
See this image and copyright information in PMC

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