Abstract
The prevalence of epiretinal membrane (ERM) and associated factors in the phakic eyes have not been fully elucidated yet. This cross-sectional study included 2,354 phakic eyes without retinal diseases or surgical history. Ocular parameters, such as uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), intraocular pressure (IOP), white-to-white corneal diameter (WTW), mean keratometric value (Km) of total corneal refractive power at 4-mm diameter (TCRP4), astigmatism of TCRP4, total corneal irregular astigmatism (TCIA), pupil diameter, axial length (AXL), anterior chamber depth (ACD), lens thickness (LT), and posterior vitreous detachment (PVD) were compared between ERM group and control group. Additionally, an age-matched control group was selected by individual matching and compared with the ERM group to eliminate the confounders. Multiple logistic regression analysis was performed to evaluate the factors associated with the presence of ERM. Among 2,354 eyes, 429 eyes (18.2%) had ERM based on spectral-domain optical coherence tomography. The ERM group showed higher prevalence of PVD, worse CDVA, higher astigmatism of TCRP4, higher TCIA, smaller pupil size, longer AXL, and thicker LT than control group (P < 0.001, P < 0.001, P = 0.011, P < 0.001, P = 0.023, P < 0.001, and P < 0.001, respectively). Only PVD, CDVA, SE, astigmatism of TCRP4, TCIA, and AXL maintained the significance when compared with the age-matched control group (P < 0.001, P = 0.026, P < 0.001, P = 0.001, P = 0.003, and P < 0.001, respectively). Multivariate logistic regression analysis showed that age, PVD, CDVA, and TCIA were independently associated with the presence of ERM (P < 0.001, P < 0.001, P = 0.011, and P = 0.002). The prevalence of ERM detected using SD-OCT was 18.2% in the middle aged phakic population. Eyes with TCIA, in addition to older age and PVD, were more likely to have ERM.
Highlights
Epiretinal membrane (ERM) is a condition of cellular proliferation at the inner retinal surface [1, 2], which has various effects on the visual quality based on its location, thickness, transparency, and contractility [3, 4]
Among the 2,354 eyes, 429 eyes (18.2%) from 297 patients showed ERM and 1,925 eyes (81.8%) showed no ERM based on spectral-domain optical coherence tomography (SD-OCT) (Table 1 and S1 Table)
The ERM group was older than control group (62.24 ± 5.31 years and 57.94 ± 5.52 years, respectively; P < 0.001)
Summary
Epiretinal membrane (ERM) is a condition of cellular proliferation at the inner retinal surface [1, 2], which has various effects on the visual quality based on its location, thickness, transparency, and contractility [3, 4]. ERM in phakic eyes population [5] to 28.9% in multiethnic U.S population [6] based on fundus photography, the prevalence significantly increased up to 69.9% in French population because the resolution of macular images markedly improved due to the introduction of spectral-domain optical coherence tomography (SD-OCT) [7, 8]. Known demographic risk factors for the development of primary ERM are age and cataract surgery, which were consistently shown in many large-scale studies [7,8,9,10,11,12]. In a recent longitudinal study using SD-OCT, the development of ERM based on aging was associated with the vitreoretinal interface (VRI), such as vitreomacular or vitreopapillary adhesion at baseline [13]. The anteroposterior movement of vitreous during cataract surgery has been hypothesized as the main cause of ERM progression in eyes that underwent cataract surgery, indicating posterior vitreous detachment (PVD) an important factor for the progression of ERM [14]
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