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IDENTIFICATION OF FACTORS RELATED TO SUBFOVEAL DETACHMENT SECONDARY TO EPIRETINAL MEMBRANE

Muftuoglu, Ilkay Kilic, MD*,†; Lin, Tiezhu, MD*; Nudleman, Eric, MD, PhD; Gaber, Raouf, MD*; Bartsch, Dirk-Uwe, PhD*; Freeman, William R., MD*

doi: 10.1097/IAE.0000000000002056
Original Study: PDF Only

Purpose: To demonstrate factors related to the presence of subfoveal detachment (SD) secondary to epiretinal membrane (ERM) and to characterize the predictors for the resolution of SD after membrane peeling.

Methods: A retrospective chart review was conducted for the patients who underwent pars plana vitrectomy for the idiopathic ERM peeling. Preoperative spectral domain optical coherence tomography characteristics of the eyes including central foveal thickness, foveal center point thickness, presence of intraretinal cyst, continuity of the membrane, area of the membrane within fovea (1 mm), and entire macula (6 mm) were evaluated to find the best predictors for the presence of SD. These predictors as well as perioperative parameters including use of internal tamponade and volume of SD were considered for time of resolution of SD.

Results: Of 158 included eyes, 20.2% eyes (32 eyes) had SD, and the presence of SD was significantly related to involvement of the membrane within the macula. After surgery, SD completely resolved in 90.6% of eyes (29 eyes) at a median of 2.97 months (range: 0.03–12.0 months). The area of the membrane within fovea was the only significant predictor for time to resolution of SD (hazard ratio = 1.20, 95% confidence interval = 1.100–1.324, P = 0.021). A small percent of eyes showed some further changes including fluctuation (6.2%) or persistence (3.1%) of fluid.

Conclusion: A larger extension of ERM over the macula is related to higher likelihood of the presence of SD. Time for resolution of subfoveal detachment does not seem to be affected by the preoperative and perioperative factors except the extent of membrane within 1,000 μm of the fovea.

*Department of Ophthalmology, Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, La Jolla, California;

Istanbul Training and Research Hospital, Istanbul, Turkey; and

Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, California.

Reprint requests: William R. Freeman, MD, Department of Ophthalmology, Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA 92037; e-mail: wrfreeman@ucsd.edu

Supported in part by NIH grant R01 EY016323-09A1 (D.U.B.), a core grant from the National Eye Institute P30 EY022589 and an unrestricted grant from Research to Prevent Blindness, NY (W.R.F.).

None of the authors has any conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.