Epiretinal Membranes Associated With Choroidal Melanoma

Purpose: To describe the prevalence of epiretinal membrane (ERM) in eyes with choroidal melanoma. Methods: A retrospective clinical case review was conducted to evaluate the prevalence of ERMs. Examinations included ophthalmoscopy, fundus photography, and optical coherence tomography. Multivariate analysis evaluated ERMs with choroidal melanoma, retinal detachment (RD) before treatment, plaque radiation dose to the fovea, radiation retinopathy, and intravitreal (IVT) antivascular endothelial growth factor (anti-VEGF) treatment. Contralateral eyes were used as controls. Results: The study included 373 patients (746 eyes). ERMs were found in 34% of eyes with choroidal melanoma that were treated and 12.1% of control eyes. A larger tumor size (increasing American Joint Committee on Cancer cT category) was significantly associated with the presence of an ERM at baseline. In addition, a higher radiation dose to the fovea was associated with ERM development. Risk factors determined by multivariate analysis included radiation retinopathy (odds ratio [OR], 3.00), anti-VEGF injections (OR, 2.87), and RD at presentation (OR, 3.19). Conclusions: This study found a significantly higher prevalence of ERMs in eyes with choroidal melanoma. Risk factors contributing to ERM development included the radiation dose, radiation retinopathy, IVT anti-VEGF injections, and RD. Of these factors, the presence of RD at the initial diagnosis was the strongest predictor of the occurrence of a secondary ERM.