The Association of Epiretinal Membrane With Macular Hole Formation After Rhegmatogenous Retinal Detachment Repair

Khurana, Rahul N.; Wykoff, Charles C.; Bansal, Alok; Akiyama, Kunihiko; Palmer, James D.; Chen, Eric; Chang, L. L.; Major, James C.; Wu, Chengqing; Wang, Rui; Croft, Daniel E.; Wong, Tien P.

doi:10.1097/iae.0000000000001307

Cited by 31 publications

(36 citation statements)

References 27 publications

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“…20 The ERM may also play a role in the pathogenesis of secondary full-thickness MH formation after RRD. 21 We had no full-thickness MHs in our study.…”

Section: Classification Of Postoperative Epiretinal Membranementioning

confidence: 89%

Internal Limiting Membrane Peeling Versus Nonpeeling to Prevent Epiretinal Membrane Development in Primary Rhegmatogenous Retinal Detachment

Arias

Padron-Perez

Flores‐Moreno

et al. 2019

Retina

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Purpose: To determine whether internal limiting membrane peeling in primary rhegmatogenous retinal detachment prevents epiretinal membrane (ERM) development. Secondarily, we propose a classification system for postoperative ERMs. Methods: Retrospective, interventional, comparative case series. Consecutive eyes with primary rhegmatogenous retinal detachment (n = 140) treated by a single surgeon. The presence of postoperative ERMs was assessed with swept-source optical coherence tomography. Results: An ERM was detected in 26 eyes (46.4%) in the nonpeeling group and in one eye (1.8%) in the internal limiting membrane peeling group (P # 0.001). The median visual acuity significantly improved in both groups (P # 0.001). Inner retinal dimples were observed in 41.1% of eyes in the internal limiting membrane peeling group versus 0% in the nonpeeling group (P # 0.001), and they were not correlated with visual acuity (r = 0.011; P = 0.941). Based on swept-source optical coherence tomography findings, we identified three different types of ERMs: 7 (26.9%) were classified as Type 1, 12 (46.1%) as Type 2, and 7 (26.9%) as Type 3. Superficial retinal plexus deformations observed on optical coherence tomography angiography and en face images were detected in 100% of Type 3 ERMs, 41.6% of Type 2, and 0% of Type 1 (x 2 = 14.3; P = 0.001). Interestingly, all of the patients who presented these alterations also had metamorphopsia. Conclusion: Internal limiting membrane peeling in primary rhegmatogenous retinal detachment seems to prevent postoperative ERM development. Swept-source optical coherence tomography analysis is helpful to define and classify different types of ERMs and to establish the surgical indication for their removal.

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“…20 The ERM may also play a role in the pathogenesis of secondary full-thickness MH formation after RRD. 21 We had no full-thickness MHs in our study.…”

Section: Classification Of Postoperative Epiretinal Membranementioning

confidence: 89%

Internal Limiting Membrane Peeling Versus Nonpeeling to Prevent Epiretinal Membrane Development in Primary Rhegmatogenous Retinal Detachment

Arias

Padron-Perez

Flores‐Moreno

et al. 2019

Retina

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“…In recent years, there have been reports of FTMH after vitreous surgery, and many of those reports observed the ERM around the MH at the time of reoperation. [ 11 , 12 ] Many preexisting diseases are prone to vulnerability in the macular region, such as ERM, rhegmatogenous RD, and retinoschisis complicated with high myopia. In this present case, due to FEVR, the ischemic and inflammatory disease, as well as due to the traction by the thick PVM, the macula region might have become fragile.…”

Section: Discussionmentioning

confidence: 99%

Familial exudative vitreoretinopathy complicated with full thickness macular hole

Kimura

Kobayashi²,

Maruyama³

et al. 2018

Medicine

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Rationale:To report a case of familial exudative vitreoretinopathy (FEVR) complicated with full-thickness macular hole (FTMH).Patient concerns:A 39-year-old male presented after becoming aware of metamorphopsia in his left eye.Diagnoses:Fundus examination showed a retinal avascular area, retinal vascular abnormality, and yellow exudation at the peripheral retina in both eyes. Optical coherence tomography findings revealed impending MH (IMH) due to posterior vitreous detachment (PVD) in his left eye. Despite of the occurrence of spontaneous complete PVD, an FTMH developed at 4 months after the onset of IMH.Interventions:To treat the FTMH, vitreous surgery was performed. Intraoperative findings revealed that the thick posterior vitreous membrane (PVM) had no adhesions with the edge of the FTMH. However, a thin epiretinal membrane (ERM) was observed around the MH.Outcomes:Postoperatively, the FTMH was closed, and the patient's corrected visual acuity improved from (0.4) to (0.8).Lessons:In this present case, an IMH developed via traction by a thick PVM, characteristic of FEVR, with FTMH then developing via traction by a thin ERM. Our findings reveal that it is vital to fully understand these anatomical features before performing vitreous surgery for FTMH complicated with FEVR.

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“…Medina et al [ 5 ] reported that the possible associations found in patients with MH formation after pars plana vitrectomy for RD included ERM, macular-off RD, recurrent RD, and high myopia, and several studies have reported that ERM was especially found as the cause of MH formation after vitrectomy for rRD [ 4 , 6 , 7 , 8 ]. Our study found no cases with conclusive macular-off or recurrent rRD, and only 1 case with high myopia (Case 4).…”

Section: Discussionmentioning

confidence: 99%

“…The underlying mechanism of macular hole (MH) formation is reported to be tangential vitreofoveal [ 1 ] and anteroposterior vitreofoveal traction [ 2 ]. However, MH formation in the vitrectomized eye, in which such traction does not exist, was reported in several articles [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. Lee et al [ 3 ] reported that the cause of MH formation after vitrectomy was epiretinal membrane (ERM), cystoid macular edema, or high myopia and suggested that MH formation within 3 months after vitrectomy was possibly iatrogenic.…”

Section: Introductionmentioning

confidence: 99%

Full-Thickness Macular Hole Formation in the Postoperative Period After Initial Vitrectomy for Rhegmatogenous Retinal Detachment

Takashina

Watanabe

Tsuneoka

2017

Case Rep Ophthalmol

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Background and Objective: To evaluate full-thickness macular hole (MH) formation in the postoperative period after initial vitrectomy for rhegmatogenous retinal detachment (rRD). Materials and Methods: We retrospectively reviewed the medical records of 4 consecutive eyes that required additional vitrectomy for full-thickness MH between April 2013 and March 2016 after undergoing an initial vitrectomy for rRD. Results: Epiretinal membrane (ERM) was identified by preoperative optical coherence tomography or intraoperative dye staining in each case. Photocoagulation of retinal breaks prior to initial vitrectomy was performed in Cases 1, 2, and 3 (4–16 days), with yttrium-aluminum-garnet capsulotomy after cataract extraction also performed prior to the retinal break formation in Case 3. At the initial vitrectomy, there was a superior retinal break which crossed the equator in Case 2, and an intentional hole was created in Cases 1 and 4. The mean interval from the initial vitrectomy until MH formation was 27.5 ± 15.8 months. As with Case 2, the intervals in Cases 1 and 4, in which an intentional hole was created, were clearly shorter than in those in Case 3. Finally, MH closure was achieved after an additional vitrectomy (removal of the internal limiting membrane with ERM and gas tamponade) and best-corrected visual acuity improved in each case. Conclusion: ERM was identified in the cases examined in our study. The presence of an intentional hole might shorten the interval of MH formation after vitrectomy for rRD.

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The Association of Epiretinal Membrane With Macular Hole Formation After Rhegmatogenous Retinal Detachment Repair

Abstract: Full-thickness macular hole formation can occur after all types of RRD repair and is associated with an epiretinal membrane. The epiretinal membrane may play a role in the pathogenesis of secondary macular hole formation after RRD repair.

Cited by 31 publications

References 27 publications

Internal Limiting Membrane Peeling Versus Nonpeeling to Prevent Epiretinal Membrane Development in Primary Rhegmatogenous Retinal Detachment

Internal Limiting Membrane Peeling Versus Nonpeeling to Prevent Epiretinal Membrane Development in Primary Rhegmatogenous Retinal Detachment

Familial exudative vitreoretinopathy complicated with full thickness macular hole

Full-Thickness Macular Hole Formation in the Postoperative Period After Initial Vitrectomy for Rhegmatogenous Retinal Detachment

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