Eyes with primary rhegmatogenous retinal detachment (RRD) that received silicone oil (SO) tamponade may be at risk for epiretinal membrane (ERM) development in some patients. Those who had preoperative proliferative vitreoretinopathy (PVR) and type 2 diabetes are particularly at risk, a study published in British Journal of Ophthalmology shows. Those who were exposed to higher photocoagulation energy, and those who had a longer SO tamponade time (SOTT) also had higher ERM risk.
The study, a retrospective analysis, looked at the risk factors for ERM in 1140 eyes of 1140 patients with RRD, who underwent primary vitrectomy and SO tamponade. ERM prevalence was estimated, and possible risk factors, including type 2 diabetes, PVR, SOTT, photocoagulation, vitreous hemorrhage, choroidal detachment, cryotherapy, and retinal tear size were analyzed using multiple logistic regression.
Researchers found that prevalence of ERM was 12.3% (140/1140), and accuracy of preoperative ERM diagnosis was 40.5%. Risk factors for ERM in eyes with SO tamponade were preoperative PVR (OR=4.336; 95% CI 2.533-7.424, P <.001), type 2 diabetes (OR=3.996; 95% CI 2.013-7.932, P <.001), photocoagulation energy (OR=1.785; 95% CI 1.306-2.439; P <.001), and SOTT (OR=1.523; 95% CI 1.261-1.840, P <.001).
“No statistically significant associations were observed between the incidence of ERM and other risk factors. Preoperative PVR showed the strongest association with risk of ERM. The risk of ERM was positively associated with SOTT, photocoagulation energy, and preoperative PVR grade,” researchers report.
The study’s main limitation was its retrospective design. More study is needed, including prospective clinical studies, to learn when and why ERM happens, researchers say. “Additionally, the mean follow-up interval in this study was short (12±6 months). Retinal detachment may recur several years after the initial surgery in some people because ERM can occur several years after SO extraction.”
Pan Q, Gao Z, Hu X, Wu Q, Zheng JW, Zhang Z-D. Risk factors for epiretinal membrane in eyes with primary rhegmatogenous retinal detachment that received silicone oil tamponade. Br J Ophthalmol. Published online February 19, 2022 doi:10.1136/bjophthalmol-2021-320121