Characteristics of epiretinal membranes according to the presence or absence of posterior vitreous detachment

Abstract

Purpose The purpose of this study is to investigate the morphological features of epiretinal membrane (ERM) in the presence or absence of a posterior vitreous detachment (PVD). Design Retrospective observational comparative case series. Methods This study involved 34 patients in whom the vitreoretinal relationship was confirmed during vitrectomy for treatment of ERM. We analyzed demography, direction of macular folds in fundus photographs, and foveal contours assessed by optical coherence tomography (OCT) in two groups of patients, the posterior vitreous attachment (PVA) group and the PVD group. Results Mean age of the 14 patients in the PVA group was 58.2±8.2 years, and that of 20 patients in the PVD group was 66.7±6.7 years (P ¼ 0.0023). Funduscopic examination revealed radiating folds in 57.1% of patients in the PVA group and 10% of patients in the PVD group, and a flat-shaped foveal contour was observed on OCT in 71.5% of patients in the PVA group and 25.0% of patients in the PVD group. Significant differences were observed between the PVA group and the PVD group in both direction of the macular folds (Po0.01) and foveal contours (P ¼ 0.028). Conclusion Patients with ERM and PVA were usually younger than 60 years. Radiating macular folds and flat foveal contour in patients with ERM are highly sensitive and specific findings indicative of PVA.

<p>Long-Term Outcomes After Idiopathic Epiretinal Membrane Surgery</p>

“…1 The pathogenesis is not fully understood, but is likely initiated during posterior vitreous detachment (PVD), 2 but some occur without PVD. [3][4][5][6] Various component cell types have been identified by histopathological analysis suggesting the potential of multiple pathogenetic mechanisms. 7 Causes of visual loss include varied degree of cell layer disruption/dysfunction and cystoid macular edema (CME).…”

Spontaneous Epiretinal Membrane Resolution and Angiotensin Receptor Blockers: Case Observation, Literature Review and Perspectives

“…In particular, we speculate that the TGF-β pathway could be the main molecular target among the different pro-inflammatory cytokine pathways that may be involved in the disease process, since it has been shown to be heavily inhibited by ARBs and ACE-Is [19]. These inhibitors, while acting upon the angiotensin receptor system (angiotensin 1 and 2 receptor (AT1R and AT2R respectively)), influence or reduce TGF-β expression and fibrosis in different organs of both animals and humans through modulating the JAK-STAT/MAPK intracellular pathways, which, in turn, influences or reduces the expression of fibronectin, collagen, and TGF-β itself [80][81][82][83].…”

Role of Vitreous Detachment in Epiretinal Membrane Peeling: A Multimodal Imaging and Microperimetry Study

“…Sometimes, induction of a posterior vitreous detachment (PVD) is required before the membrane’s removal. In fact, PVD is present in around 80% of patients with idiopathic ERM [ 2 ]. The presence of an incomplete PVD may determine a more technically difficult procedure, with a complexity of forces which acts peripherally, increasing the risk for iatrogenic retinal breaks [ 3 , 4 ].…”