Prevalence of epiretinal membranes in the ageing population using retinal colour images and SD‐OCT: the Alienor Study

Abstract

To analyse and compare the prevalence of epiretinal membranes (ERMs) obtained using either standard retinal colour images or spectral-domain optical coherence tomography (SD-OCT) in a population-based setting of French elderly subjects. Methods: Six hundred twenty-four subjects of the Alienor cohort aged 75 years or older underwent both colour fundus imaging and SD-OCT examinations. The ERMs were graded from retinal images and SD-OCT macular scans in a masked fashion. On SD-OCT images, the early ERMs, mature contractile ERMs without foveal modifications and mature contractile ERMs with foveal alterations were distinguished. Results: 610 (97.8%) subjects had gradable SD-OCT examinations, and 511 (81.9%) had gradable fundus images in at least one eye. According to colour photographs, 11.6% of participants had definite ERMs. From SD-OCT images, 52.8% of the subjects had early ERMs, 7.4% had mature ERMs without foveal involvement, and 9.7% had mature ERMs with foveal alterations. Regardless of the imaging method used, the ERMs were more often observed in pseudophakic eyes than in phakic eyes. Comparison of ERM assessment using fundus photographs versus SD-OCT images demonstrated that the specificity of retinal colour images was good (>89.3%), whereas the sensitivity remained low even though it increased with ERM severity on SD-OCT images. Conclusions: Spectral-domain optical coherence tomography (SD-OCT) examinations have high feasibility in this elderly population and are much more sensitive than standard colour images for ERM assessments, especially in the early stages of the disease. Our results further highlight the need to use SD-OCT instead of colour retinal photographs for the classification of ERMs in epidemiological studies.

Prevalence of epiretinal membrane in the phakic eyes based on spectral-domain optical coherence tomography

“…In the Beaver Dam Eye Study (BDES) [7], which was conducted in the USA population (mean age 74.1 years, both phakic and pseudophakic), the prevalence of ERM was 34.1% of the enrolled eyes. The Alienor study [8], which was conducted in the…”

“…Definitions. The ERM severity was graded as previously defined by Delyfer et al [8]: (1) stage 1 or continuous hyperreflectivity, presence of a continuous hyperreflective signal at the inner retinal surface on at least three consecutive sections of the macular cube; (2) stage 2 or mature ERM without foveal involvement, stage 1 associated with retinal folds but without alterations of the foveal depression; (3) stage 3 or mature ERM with foveal involvement, stage 2 associated with foveal depression alterations.…”

“…Although ERM is a highly prevalent disease [5,6], the pathophysiology of ERM, especially primary ERM, is not yet fully understood. Known demographic risk factors for the development of primary ERM are age and cataract surgery, which were consistently shown in many large-scale studies [7][8][9][10][11][12]. In a recent longitudinal study using SD-OCT, the development of ERM based on aging was associated with the vitreoretinal interface (VRI), such as vitreomacular or vitreopapillary adhesion at baseline [13].…”

“…Epiretinal membrane (ERM) is a condition of cellular proliferation at the inner retinal surface [1,2], which has various effects on the visual quality based on its location, thickness, transparency, and contractility [3,4]. The prevalence of ERM reportedly ranged from 1.02% in Chinese population [5] to 28.9% in multiethnic U.S. population [6] based on fundus photography, however, the prevalence significantly increased up to 69.9% in French population because the resolution of macular images markedly improved due to the introduction of spectral-domain optical coherence tomography (SD-OCT) [7,8].…”

“…In a previous study in which the PVD in healthy human eyes was evaluated using OCT, an incomplete or partial PVD began as early as the fourth decade of life and slowly progressed to an advanced stage in subsequent decades [15]. In most studies, ERM [5][6][7][8] and PVD [16][17][18] were evaluated in an older cohort, around the seventh decade of life. Only limited information exists regarding ERM and PVD in middle-aged subjects in the fifth and sixth decade of life, which is presumably the period when ERM [5,6] and PVD start [15].…”