Clinical Ophthalmology (Oct 2017)
Epiretinal membrane and cystoid macular edema as predictive factors of recurrent proliferative vitreoretinopathy
Abstract
Kunyong Xu,1 Eric K Chin,2 D Wilkin Parke III,3 David RP Almeida3 1Department of Ophthalmology, Weill Cornell Medicine, Cornell University, New York, NY, 2Retina Consultants of Southern California, Redlands, CA, 3VitreoRetinal Surgery, PA, Minneapolis, MN, USA Purpose: Proliferative vitreoretinopathy (PVR) is the most common cause of recurrent retinal detachment (RD). We sought to determine the predictive factors of recurrent PVR formation and the need for additional vitreoretinal surgical intervention after uncomplicated primary RD repair.Methods: This is a retrospective single-center case–control study of consecutive patients with PVR formation after uncomplicated RD repair. Logistic regression was used to assess factors associated with recurrent PVR formation.Results: Thirty-seven eyes (37 patients) who had recurrent RD secondary to PVR formation were included. Among those, 27 eyes needed one additional surgery, whereas the remainder 10 eyes required two or more additional surgeries. In the univariate analysis, patients who had cystoid macular edema (CME) after the second surgery were 8.33 times (crude odds ratio [COR], 95% confidence interval [CI]: 1.23–56.67, p=0.0302) more likely to have recurrent PVR formation compared to those who did not have CME after the second surgery. Similarly, those who had epiretinal membrane (ERM) after the second surgery were 8.00 times (COR, 95% CI: 1.43–44.92, p=0.0182) more likely to have recurrent PVR formation compared to those who did not have ERM after the second surgery. In the multivariate analysis, patients who had ERM after the second surgery were 8.20 times (adjusted odds ratio [AOR], 95% CI: 1.08–62.40, p=0.0422) more likely to develop recurrent PVR compared to those who did not have ERM after the second surgery, when adjusted for age, sex, and CME after the second surgery.Conclusion: ERM and CME are potential predictive factors for recurrent PVR formation after uncomplicated primary RD repair. Early recognition and treatment of ERM and CME may be critical to prevent subsequent PVR formation and improve visual outcomes. Keywords: epiretinal membrane, cystoid macular edema, proliferative vitreoretinopathy, retinal detachment, rhegmatogenous retinal detachment
