Association between Treated Retinal Breaks and Epiretinal Membrane Development

Area of Science:

• Ophthalmology
• Retinal Surgery
• Vitreoretinal Diseases

Background:

• Retinal breaks (RBs) without detachment are commonly treated with laser retinopexy or cryotherapy.
• Epiretinal membrane (ERM) formation is a potential complication following retinal procedures.
• The temporal relationship between RB treatments and ERM development requires further investigation.

Purpose of the Study:

• To evaluate the temporal association between laser retinopexy or cryotherapy for RBs without detachment and the subsequent development of ERM.
• To compare the incidence of ERM formation and ERM peel between treated and untreated RBs.
• To directly compare ERM risk between laser retinopexy and cryotherapy cohorts.

Main Methods:

• Retrospective cohort study utilizing a national clinical database (TriNetX).
• Propensity score matching (PSM) was employed to compare 20,191 laser retinopexy patients and 730 cryotherapy patients against matched untreated RB controls.
• Incidence of ERM formation and ERM peel was analyzed from three months to five years post-intervention.

Main Results:

• Both laser retinopexy and cryotherapy cohorts showed an increased risk of ERM formation early after treatment compared to controls.
• In the laser cohort, ERM risk was elevated at three months (RR, 3.06) and one year (RR, 2.77), with persistent higher ERM peel rates.
• In the cryotherapy cohort, ERM risk was elevated at six months (RR, 2.79) and one year (RR, 3.32). No significant differences in ERM risk were found between laser and cryotherapy.

Conclusions:

• Treatment of RBs without detachment with laser retinopexy or cryotherapy is associated with an increased risk of ERM formation.
• The risk of ERM development peaks early post-treatment and persists over the five-year study period.
• ERM development may be a response to vitreoretinal disruption and inflammation, irrespective of the specific treatment modality used.