Abstract
BackgroundThe purpose of this study is to evaluate the influence of anti-vascular endothelial growth factor (VEGF) in the appearance or progression of epiretinal membranes (ERMs) in age-related macular degeneration (ARMD) and investigate confounding factors causing ERMs.MethodsSeventy-six eyes that were treated for more than 36 months from the first anti-VEGF injection were assessed. Binary logistic regression analysis was performed between smoking, lens status, subretinal hemorrhage, posterior vitreous detachment (PVD) status, peripheral retinal degeneration, type of AMD, conditions of contralateral eye, and the number of injections as independent variables and appearance or progression of ERMs during 36 months as dependent variables.ResultsThe presence of vitreomacular adhesion (VMA) or development of PVD during the observation period was significantly associated (Odds ratio [OR]: 5.77; 95% confidence interval [CI], 1.72–19.4; p = 0.005) with the appearance or progression of ERMs. Moreover, peripheral retinal degeneration was significantly associated (OR: 3.87; 95% CI, 1.15–13.0; p = 0.029). Injection number of anti-VEGF was not significantly associated (OR: 1.02; 95% CI, 0.90–1.16; p = 0.72).ConclusionThis study suggests possibilities that anti-VEGF injections alone are unable to cause the development of ERMs, that VMA or developing PVD has a prior impact on the developing ERMs in ARMD similar to that of idiopathic ERMs, and that peripheral retinal degenerations and vitreomacular adhesion were both related to ERMs development and pathogenesis of ARMD.
Highlights
The purpose of this study is to evaluate the influence of anti-vascular endothelial growth factor (VEGF) in the appearance or progression of epiretinal membranes (ERMs) in age-related macular degeneration (ARMD) and investigate confounding factors causing ERMs
Marticorena et al reported that 4/25 (16%) eyes injected with anti-VEGF drugs progressed ERMs 6–7 weeks after injection had Taniguchi et al BMC Ophthalmology (2021) 21:190 been diagnosed 5.5–12.5 months earlier [6]. They suggested that regression of VEGF led to decreased nitric oxide (NO) and could induce hypoxia, resulting in upregulation of platelet derived growth factor (PDGF)-A, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β, and ERMs progression [7,8,9]
We investigated confounding factors causing ERMs (1) smoking [13, 14]; (2) lens status: phakia, pseudophakia, or undergone cataract surgery during the 36 months [15]; (3) subretinal hemorrhage larger than 4-disc area; (4) posterior vitreous detachment (PVD) status: no PVD, complete PVD, anomalous PVD, or progression of PVD during the 36 months [16]; (5) lattice degeneration or any other peripheral retinal degeneration;(6) type of exudative AMD; (7) conditions of the contralateral eye [15]; (8) number of injections; and built binary logistic regression analysis to evaluate the multivariate associations between those independent variables and appearance or progression of ERMs as a dependent variable
Summary
The purpose of this study is to evaluate the influence of anti-vascular endothelial growth factor (VEGF) in the appearance or progression of epiretinal membranes (ERMs) in age-related macular degeneration (ARMD) and investigate confounding factors causing ERMs. Marticorena et al reported that 4/25 (16%) eyes injected with anti-VEGF drugs progressed ERMs 6–7 weeks after injection had Taniguchi et al BMC Ophthalmology (2021) 21:190 been diagnosed 5.5–12.5 months earlier [6]. They suggested that regression of VEGF led to decreased nitric oxide (NO) and could induce hypoxia, resulting in upregulation of platelet derived growth factor (PDGF)-A, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β, and ERMs progression [7,8,9]. A similar condition could appear after intravitreal injection against ARMD, though no issue in BRVO or ARMD has been investigated further
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