Epiretinal Membrane Formation Following Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment

The aim of this study was to investigate epiretinal membrane (ERM) formation and progression after pneumatic retinopexy (PR) using optical coherence tomography (OCT)-based biomarkers.

A retrospective review of post-PR eyes between January 2015 and June 2022 was performed. ERM progression and visual outcomes during follow-up were evaluated using OCT structural analysis and a standard grading scheme.

Among 894 PR-treated eyes, 120 developed ERM over an average of 37 months. Most eyes (84.2%) were observed, while 15.8% underwent membrane peeling (MP) at a mean of 12.5 months post-PR. ERM remained stable in 94% of observed cases, with 6% progressing within 6 months. MP was associated with laser retinopexy after PR (OR = 3.38; 95% CI [1.22-9.38]; P = .020), worse visual acuity (VA) at ERM diagnosis (OR = 4.18; [1.85-9.43]; P < .001), higher CFT at ERM diagnosis (OR = 1.007; [1.002-1.012]; P = .005), EZ disruption (OR = 6.38; [1.69-24.12]; P = .006), and microcystic changes (OR = 4.89; [1.62-14.73]; P = .008).

Post-PR ERMs were typically stage 1 or 2 with minimal progression over 3 years. Laser retinopexy after PR, worse VA at ERM diagnosis, higher central foveal thickness at ERM diagnosis, ellipsoid zone disruption, and the presence of microcystic changes were associated with the need for MP.