PERIPHERAL RETINAL ANGIOGRAPHIC FEATURES IN EYES WITH IDIOPATHIC EPIRETINAL MEMBRANE:: An Ultra-Widefield Fluorescein Angiography Comparison With Fellow Unaffected Eyes.

PURPOSE: This study aimed to investigate peripheral retinal angiographic features using ultra-widefield fluorescein angiography (UW-FAG) in eyes with idiopathic epiretinal membrane (iERM), compare them with fellow unaffected eyes, and assess their association with disease severity.

METHODS

This retrospective study included 84 patients (168 eyes) with unilateral iERM. UW-FAG images were analyzed in both eyes, and peripheral angiographic findings were categorized as vascular-associated or nonvascular. The frequencies of these features were compared between iERM and fellow unaffected eyes. The iERM eyes were further classified as early (Stages 1-2) or advanced (Stages 3-4) according to optical coherence tomography grading.

RESULTS

The mean age of patients was 65.1 ± 7.3 years, and 64.3% were female. Peripheral abnormalities were significantly more frequent in iERM eyes, including granular hyperfluorescence (39.3% vs. 15.5%, P < 0.001), late-phase leakage (89.3% vs. 56.0%, P < 0.001), and microaneurysms (60.7% vs. 31.0%, P < 0.001). Advanced-stage iERM eyes showed higher rates of late-phase leakage (53.8% vs. 23.8%, P < 0.001), microaneurysms (59.0% vs. 31.0%, P = 0.001), and granular hyperfluorescence (26.9% vs. 7.1%, P = 0.005). The iERM severity positively correlated with late-phase leakage (r = 0.32, P = 0.0008) and microaneurysms (r = 0.25, P = 0.007).

CONCLUSIONS

Peripheral angiographic abnormalities are more prevalent in iERM eyes and correlate with disease severity. These findings suggest that iERM is not confined to the macula but may reflect broader retinal pathophysiology. UW-FAG serves as a valuable adjunctive tool in comprehensively evaluating eyes with iERM.