Significant gains in visual acuity (VA) were recorded in eyes undergoing membrane peel after retinal detachment (RD) repair, independent of macula-status at the time of RD repair, explains a study in Ophthalmology Retina.

Researchers conducted a retrospective chart review to assess VA outcomes of epiretinal membrane (ERM) surgery following primary rhegmatogenous RD repair. An ERM grading scale was used for structural analysis of data recorded using optical coherence tomography (OCT) from 2015 to 2018. 53 eyes of 53 patients undergoing pars plana vitrectomy (PPV) with MP surgery following primary RD repair were included in the study.

The results show a significant improvement in VA at the 6-month point and at final follow-up (P <.001). The improvement in VA was significant in both macula-on and macula-off eyes (P <.0001), but better 6-month (P =.02) and final (P =.04) follow-up outcomes were seen in eyes with macula-on detachments. 


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The researchers identified a trend of worse premembrane peel acuities in eyes classified into higher ERM stages (P =.06). Worse pre-MP VA was associated with MP occurring before 180 days from RD repair (P =.01) and ellipsoid zone loss (P =.0003). 

The study notes that the lack of a significant difference in VA between macula-on and macula-off eyes premembrane peel and postmembrane peel has a reasonable explanation.

“This suggests that ERM formation has a clinically meaningful effect on VA independent of macula status once ERM development has occurred,” the researchers explain. 

The study also points out that its finding of a brief period from RD repair to first diagnosis of ERM (3 months) and of visually significant ERM (6 months) aligns with the findings of previous studies.

The researchers note study limitations including its retrospective nature, possible selection bias, and a possible underestimation of visual potential in post-RD, postmembrane peel eyes due to a sample weighted to a higher proportion of patients with Stage 4 ERMs. Also, they point out a possible underestimation of VA outcomes due to the use of Snellen visual acuity with habitual correction or pinhole and without refraction.

Reference

Soares R, Mahmoudzadeh R, Salabati M, Massenzio E, et al. Epiretinal membrane surgery after retinal detachment repair: visual acuity outcomes and optical coherence tomography analysis. Ophthalmol Retina. March 29, 2021. doi:10.1016/j.oret.2021.03.013.