Photocoagulation-associated spontaneous release of epiretinal membrane secondary to retinal vascular tumor: case series of 8 cases

Resolution of epiretinal membrane after anti-VEGF and photodynamic therapy of retinal hemangioblastoma

“…Epiretinal membrane or vitreoretinal tractions spontaneous release is rare (3–6%); it is more commonly described in women, and myopes. 8 , 10 , 11 Previous reports observed this phenomenon following laser photocoagulation and cryotherapy. 11 In our case, we observed a peeling of the macular epiretinal membrane after anti-VEGF and photodynamic therapy, without the need of surgical intervention.…”

Case Report: Exacerbation and Spontaneous Separation of the Epiretinal Membrane Following Laser Photocoagulation of a Vasoproliferative Tumor of the Retina

“…A previous study found that the secondary ERM identified in a VPTR case was mainly comprised of a hyaline membrane with positive staining for type IV collagen and glial fibrillary acidic protein, which was determined to be identical to the posterior hyaloid membrane (20). In addition, photocoagulation-related retinal gliosis and inflammation might increase the contractile activity of an ERM (15). Thus, we hypothesized that the secondary ERMs seen in some cases of VPTR might stem from a disturbed vitreous.…”

“…In our case, the VPTR was diagnosed on the basis of the FA and ICGA findings combined with the pink fundus mass and normal vessel findings. Prior studies involving patients with VPTR have achieved satisfactory therapeutic effects using cryotherapy (mean tumor diameter: 6 mm; tumor resolution: 16 previously been reported to achieve the regression of the tumor in cases of VPTR (11,15). A VPTR is generally associated with vision-threatening complications, especially ERM and macular edema (1,5,6).…”

“…However, the spontaneous separation of the ERM was observed in 3% of the 1,248 tested eyes, which indicates that some patients could have avoided surgical intervention (16). Posterior vitreous detachment (PVD) is presumed to be an important pathological process related to spontaneous ERM separation (16), which may be associated with LP (15) and cryotherapy (14). In our case, the OCT conducted before the second round of LP showed no signs of PVD, while the ERM was shown to be tightly adhered to the retina.…”

“…Due to safety concerns, most ophthalmologists consider vitrectomy to be the treatment method of choice when an ERM is formed. However, a few cases of the spontaneous separation of the secondary ERM have been reported in patients with VPTR (14,15). Surgical intervention could be avoided in approximately 3% of ERM cases (16).…”