Optical Coherence Tomography Biomarkers Differentiate Epiretinal Membranes Secondary to Retinal Detachment from Idiopathic Epiretinal Membranes.

Purpose: To identify distinguishing optical coherence tomography (OCT) characteristics of epiretinal membranes (ERMs) secondary to retinal detachment compared with idiopathic ERMs.

Methods

This retrospective study analyzed 2 cohorts treated at a tertiary referral center: ERM following rhegmatogenous retinal detachment (RRD) and idiopathic ERM. Only patients who underwent pars plana vitrectomy with membrane peeling were included. Preoperative OCT images were reviewed and graded.

Results

Postoperative best-corrected visual acuity improved in both groups. In the post-RRD ERM cohort, visual acuity improved from 0.71 to 0.64 (Snellen equivalents, approximately 20/100 to 20/80), while in the idiopathic ERM cohort, it improved from 0.44 to 0.32 (approximately 20/60 to 20/40). Post-RRD ERMs were of higher stage, with 80% classified as stage 3 or 4 compared with 61% in the idiopathic group (P = .048). Disorganization of the retinal inner layers was more prevalent in post-RRD ERM, with 42% demonstrating grade 3 or 4 compared with 15% in idiopathic ERM (P = .02). Foveal herniation was observed in 40% of post-RRD ERMs compared with 14% of idiopathic ERMs (P = .009). A gap between the ERM and the retinal surface was more frequently identified in idiopathic ERM (62%) than in post-RRD ERM (17%) (P < .001).

Conclusions

ERMs following RRD exhibit more severe OCT characteristics, including higher staging, increased prevalence of foveal herniation, and lower incidence of a gap between the ERM and the retinal surface. The presence of these OCT characteristics should raise suspicion for prior retinal tear or retinal detachment and may indicate a worse visual prognosis and increased surgical complexity.