Prevalence, correlates, and natural history of epiretinal membranes surrounding idiopathic macular holes

Abstract

Objective To report on the prevalence, correlates, and natural history of epiretinal membranes (ERM) in eyes with stage II or III/IV macular holes. Design A subgroup analysis arising from a multicentered, controlled, randomized clinical trial. Setting Community and university-based ophthalmology clinics. Patients Two hundred twenty four eyes with stage II or III/IV macular holes. Interventions No intervention for 100 eyes randomly assigned to observation. Outcome measures Grade of ERM determined by stereoscopic examination of fundus photographs at baseline and at 3, 6, 12, and 24 months of follow-up. Results The prevalence of ERM was 65% (145 of 224 eyes), was greater in pseudophakic than in phakic eyes (80% vs. 63%, P = 0.10), and increased with increasing severity of the hole ( P < 0.0001). Stage III/IV eyes with ERM had a significantly larger hole size than did eyes without ERM ( P < 0.01); however, no association between presence of ERM and visual acuity was found ( P > 0.5). In the 100 phakic eyes that were randomly assigned to observation, there was a significant increase in the severity of ERM over follow-up ( P < 0.0001). Conclusions ERM are common in eyes with full-thickness idiopathic macular holes. Although ERM prevalence increases with severity and size of the macular hole, the presence of ERM are not closely correlated with visual acuity. These factors may be important in considering the removal of ERM during vitrectomy for macular hole.