Abstract
The purpose of this study was to investigate the incidence of secondary epiretinal membrane (ERM) after intravitreal injection and the effect of ERM on visual acuity and central macular thickness (CMT) in patients with diabetic macular edema (DME). We included 147 eyes of 95 patients over 18 years old who were diagnosed with DME from 2012 to 2016, treated with intravitreal injection, and followed-up more than 24 months. Mean CMT in the ERM group was significantly thicker than in the non-ERM group after 9, 12, 18, and 24 months. Secondary ERM developed in 9.5% of patients during follow-up. Compared to other agents, the incidence of secondary ERM was significantly higher after intravitreal injection of dexamethasone implant. Among patients in the ERM group, the mean decrease of CMT between pre-injection and 2 weeks post-injection was significantly less after secondary ERM formation than before ERM formation. Secondary ERM formation was significantly associated with the number of intravitreal injections and the use of dexamethasone implant. Therefore, secondary ERM develops more frequently as the number of intravitreal injections increases and after intravitreal dexamethasone implant injection. The therapeutic effects of intravitreal injections for DME patients decrease after secondary ERM formation.
Highlights
The purpose of this study was to investigate the incidence of secondary epiretinal membrane (ERM) after intravitreal injection and the effect of ERM on visual acuity and central macular thickness (CMT) in patients with diabetic macular edema (DME)
We investigated the incidence of secondary ERM and the effect of ERM on visual acuity and central macular thickness (CMT) among DME patients who received intravitreal injections
We performed this study investigating secondary ERM among vitreomacular interface abnormality (VMIA) based on optical coherent tomography (OCT) findings, and we found that 9.5% of eyes developed secondary ERM after intravitreal injection
Summary
The purpose of this study was to investigate the incidence of secondary epiretinal membrane (ERM) after intravitreal injection and the effect of ERM on visual acuity and central macular thickness (CMT) in patients with diabetic macular edema (DME). The incidence of secondary ERM was significantly higher after intravitreal injection of dexamethasone implant. Secondary ERM formation was significantly associated with the number of intravitreal injections and the use of dexamethasone implant. The therapeutic effects of intravitreal injections for DME patients decrease after secondary ERM formation. ERM may act as a physical barrier and decrease drug penetration after intravitreal injections of anti-VEGF or steroids in DME treatment[10]. We investigated the incidence of secondary ERM and the effect of ERM on visual acuity and central macular thickness (CMT) among DME patients who received intravitreal injections. We analyzed parameters contributing to secondary ERM formation following intravitreal injection
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