Characteristics of spontaneous idiopathic epiretinal membrane separation in spectral domain optical coherence tomography.

Abstract

To investigate the prevalence, characteristics, and visual acuity of spontaneous idiopathic epiretinal membrane (ERM) separations using spectral domain optical coherence tomography. In a series of 1,248 consecutive eyes with idiopathic ERM, Group I with preexisting posterior vitreous detachment included 1,091 eyes (87.4%) and Group II without preexisting posterior vitreous detachment included 157 eyes (12.6%). Groups IA and IIA included self-resolution cases of ERM from Groups I and II, respectively. The ERM self-separation occurred in 37 eyes (3.0%) for 32.6 ± 11.7 months, with 16 eyes (1.5%) in Group IA and 21 eyes (13.4%) in Group IIA. The mean best-corrected visual acuity (logMAR) improved in Groups IA and IIA by 0.1 (P = 0.013) and 0.06 (P = 0.078), respectively. From tomographic analyses, dominant undulation and retinal nerve fiber layer defects were more frequent in Group IA than Group IIA (P < 0.001 and P = 0.024, respectively). However, the completeness of ERM separation, inner segment/outer segment junction defects, and ERM recurrence were more frequent in Group IIA than Group IA (P = 0.039, P = 0.023 and P = 0.041, respectively). Multivariate analysis for factors related to visual improvement revealed only inner segment/outer segment junction defects as significantly associated (P = 0.025). Different mechanisms underlying the self-resolution of idiopathic ERM lead to distinct tomographic characteristics and may affect the postseparation visual function.