Assessment of epiretinal membrane formation using en face optical coherence tomography after rhegmatogenous retinal detachment repair

Purpose To investigate epiretinal membrane (ERM) formation using en face optical coherence tomography (OCT) after vitrectomy for rhegmatogenous retinal detachment (RRD). Methods We retrospectively reviewed the medical records of 64 consecutive eyes (64 patients) with RRD treated by vitrectomy without ERM and internal limiting membrane peeling. ERMs and retinal folds were detected by B-scan and en face imaging. The maximum depth of retinal folds (MDRF) was quantified using en face imaging. ERM severity was staged using B-scan imaging. Main outcome measures were ERM detection rate with B-scan and en face imaging, MDRF, ERM staging, postoperative best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution), and risk factors for ERM formation. Results The detection rate for ERM formation was significantly higher with en face imaging (70.3%) than with B-scan imaging (46.9%; P = 0.007). There was no significant difference in postoperative BCVA between eyes with ERM formation (0.06 +/- 0.26) and those without ERM formation (0.01 +/- 0.14; P = 0.298). Forty of 45 (88.9%) eyes with ERM formation were classified as stage 1. Twenty-seven of 45 (60.0%) eyes with ERM formation developed parafoveal retinal folds. The mean MDRF was 27.4 +/- 32.2 mu m. Multiple retinal breaks and a maximum retinal break size of >= 2 disc diameters were significantly associated with ERM formation (P = 0.033 and P = 0.031, respectively). Conclusion Although ERM formation was observed in 70.3% patients after RRD repair, the formed ERM was not severe and had minimal impact on the postoperative visual acuity.

Automated summary

Using en face optical coherence tomography for epiretinal membrane (ERM) detection after vitrectomy for rhegmatogenous retinal detachment (RRD) showed a significantly higher detection rate compared to B-scan imaging. ERM formation in the majority of eyes did not significantly affect postoperative visual acuity, with most cases classified as stage 1 and a majority showing parafoveal retinal folds. Multiple retinal breaks and larger retinal break sizes were associated with increased risk of ERM formation.