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Epiretinal membrane recurrence: incidence, characteristics, evolution, and preventive and risk factors
Otman Sandali1, Mohamed El Sanharawi, Elena Basli
1*Department of Ophthalmology V and ‡Department of Ophthalmology IV, Quinze-Vingts National Ophthalmology Hospital, Paris, France; and †National Institute of Health and Medical Research, Cordeliers Research Center, Team 17, Physiopathology of Ocular Diseases, Therapeutic Innovations, Pierre and Marie Curie University, Paris, France.
Background:
To evaluate the incidence, evolution, clinical characteristics, possible risk factors or preventive factors, and visual outcomes of epiretinal membrane (ERM) recurrence.
Methods:
Retrospective study of 440 consecutive patients (440 eyes) who underwent pars plana vitrectomy for ERM. The internal limiting membrane (ILM) was peeled in 266 cases, with the help of indocyanine green in 27 cases and brilliant blue in 45 cases. Cases of symptomatic ERM recurrence were reoperated.
Results:
The incidence of ERM recurrence was 5% (22/440), and 2% of the patients were reoperated (9/440). Epiretinal membrane recurrence was symptomatic in 9 cases (41%) and asymptomatic in 13 cases (59%). ILM peeling was the only factor preventing ERM recurrence (adjusted odds ratio = 0.33, P = 0.026). The use of staining dyes did not prevent recurrence (adjusted odds ratio = 0.35, P = 0.338). In the case of ERM reproliferation, the absence of ILM peeling, the existence of ERM on the fellow eye, and poor visual acuity before surgery seemed to be associated with a high risk of symptomatic recurrence and reoperation. The mean duration for follow-up was 3.5 ± 1.7 years.
Conclusion:
ILM peeling not only reduces the likelihood of reproliferation of ERM but also seems to improve the visual prognosis of recurrent ERMs. The use of dyes did not reduce the rate of recurrence compared with when ILM was peeled without dyes.
