Diabetic Epiretinal Membranes Unveiled: Exploring Staging and Optical Coherence Tomography-Based Classification for Precise Characterization

Abstract

Background/Objectives:To evaluate the applicability of an OCT-based staging system for diabetic epiretinal membranes (ERMs) and investigate the vascular and anatomical distinctions between idiopathic and diabetic ERMs. Subjects/Methods:A total of 142 eyes of diabetic, idiopathic ERM patients and controls were retrospectively analysed. The OCT-based staging system by Govetto et al. was used for classifying ERMs into stages. Correlations were established between OCT-A parameters, visual acuity (VA), ERM stage, and structural findings on OCT. Results:It was accepted p-value <0.05 as significant level on all statistical analysis.Ectopic inner foveal layer thickness (EIFL) showed no significant difference between ERM groups but positively correlated with stage severity in both. Positive correlation observed between the the stage and the central foveal thickness (CFT), outer and inner retinal layer (IRL) thickness in both groups. CFT exhibited positive correlations with Macular vessel density ratio (MVR) and negative correlations with foveal avascular zone (FAZ) in both groups. Conclusion:OCT-based staging developed for idiopatic ERMs was found to be applicable to diabetic cases without retinopathy. Mechanical traction in idiopathic ERM primarily affects the IRL and retinal blood flow. The presence of significant correlations between retinal thickness and MVR strengthens our findings, as it highlights the meaningful relationship between tractional thickening and vascular distortion in both idiopathic and diabetic ERM cases.