Epiretinal membrane formation following laser photocoagulation for peripheral retinal degeneration: incidence and risk factors.

PURPOSE: Laser photocoagulation remains the most common treatment for peripheral retinal degeneration. However, potential side effects, particularly inflammation and gliosis, raise concerns about an increased risk of epiretinal membrane (ERM) formation. This study aims to further investigate the association between laser photocoagulation and ERM formation and identify associated risk factors.

METHODS

This retrospective study included patients who underwent retinal laser photocoagulation for peripheral retinal degeneration. Clinical data including medical history, ophthalmic examinations during follow-up, and details of the laser photocoagulation, were recorded. Binary regression analysis was used to assess risk factors for ERM formation, including age, ocular findings, and laser parameters.

RESULTS

Among the 726 eyes, 32 eyes (4.41%) developed ERM during a follow-up period of 29.7 ± 17.2 months. Risk factors included older age (53.9 ± 11.1 vs. 36.6 ± 17.3 years, P < 0.001), presence of lattice degeneration (62.5% vs. 40.3%, P < 0.001), greater number of laser spots (390.1 ± 171.9 vs. 284.8 ± 156.4, P < 0.001), higher total laser energy (22.5 ± 10.8J vs. 13.6 ± 11.9J, P < 0.001), wider extent of laser coverage (4.47 ± 3.38 vs. 3.08 ± 2.10 clock hours, P = 0.028), and shorter distance between the laser and the fovea (7.50 ± 1.72 vs. 8.36 ± 2.16 disc diameters, P = 0.017). Further regression analysis identified age (OR 1.071, 95% CI 1.040-1.102), number of laser spots (OR 1.003, 95% CI 1.001-1.005), and extent of laser coverage (OR 1.178, 95% CI 1.025-1.354) as independent risk factors for ERM development.

CONCLUSIONS

Peripheral retinal laser photocoagulation does not significantly increase the incidence of ERM. However, careful control of the number and extent of laser applications may help minimize potential damage to the macula.