Idiopathic Epiretinal Membranes – Pathophysiology, Classifications and OCT-Biomarkers

Abstract

Epiretinal membranes (ERMs) are a common finding in patients with increasing age. Diagnosis and treatment of ERMs have changed dramatically in recent years due to technological advances in ophthalmological care. In recent years, tomographic imaging has allowed for accurate visualization of ERMs and contributed to the growing understanding of the pathophysiology of this condition. The literature review conducted here summarizes recent innovations in diagnosis, classification, and treatment of idiopathic ERMs and specifically addresses novel optical coherence tomography (OCT) biomarkers that allow for the generation of prognoses regarding the clinical postoperative outcome.

Key words

macular pucker - optical coherence tomography - prognosis - surgery - epiretinal membrane - OCT

Publication History

Received: 18 January 2023

Accepted: 20 February 2023

Accepted Manuscript online:
27 February 2023

Article published online:
19 June 2023

• References/Literatur

• 1 da Silva RA, Roda VMP, Matsuda M. et al. Cellular components of the idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2022; 260: 1435-1444 DOI: 10.1007/s00417-021-05492-7.
• 2 Meuer SM, Myers CE, Klein BE. et al. The epidemiology of vitreoretinal interface abnormalities as detected by spectral-domain optical coherence tomography: the beaver dam eye study. Ophthalmology 2015; 122: 787-795 DOI: 10.1016/j.ophtha.2014.10.014.
• 3 Chua PY, Sandinha MT, Steel DH. Idiopathic epiretinal membrane: progression and timing of surgery. Eye (Lond) 2022; 36: 495-503 DOI: 10.1038/s41433-021-01681-0.
• 4 Govetto A, Virgili G, Rodriguez FJ. et al. Functional and Anatomical Significance of the Ectopic Inner Foveal Layers in Eyes with Idiopathic Epiretinal Membranes: Surgical Results at 12 Months. Retina 2019; 39: 347-357 DOI: 10.1097/IAE.0000000000001940.
• 5 Klein R, Klein BE, Wang Q. et al. The epidemiology of epiretinal membranes. Trans Am Ophthalmol Soc 1994; 92: 403-425
• 6 Mitchell P, Smith W, Chey T. et al. Prevalence and associations of epiretinal membranes. The Blue Mountains Eye Study, Australia. Ophthalmology 1997; 104: 1033-1040 DOI: 10.1016/s0161-6420(97)30190-0.
• 7 Quinn NB, Steel DH, Chakravarthy U. et al. Assessment of the Vitreomacular Interface Using High-Resolution OCT in a Population-Based Cohort Study of Older Adults. Ophthalmol Retina 2020; 4: 801-813 DOI: 10.1016/j.oret.2020.02.013.
• 8 Ng CH, Cheung N, Wang JJ. et al. Prevalence and risk factors for epiretinal membranes in a multi-ethnic United States population. Ophthalmology 2011; 118: 694-699 DOI: 10.1016/j.ophtha.2010.08.009.
• 9 Xiao W, Chen X, Yan W. et al. Prevalence and risk factors of epiretinal membranes: a systematic review and meta-analysis of population-based studies. BMJ Open 2017; 7: e014644 DOI: 10.1136/bmjopen-2016-014644.
• 10 Gupta P, Yee KM, Garcia P. et al. Vitreoschisis in macular diseases. Br J Ophthalmol 2011; 95: 376-380 DOI: 10.1136/bjo.2009.175109.
• 11 Bu SC, Kuijer R, Li XR. et al. Idiopathic epiretinal membrane. Retina 2014; 34: 2317-2335 DOI: 10.1097/IAE.0000000000000349.
• 12 Schumann RG, Gandorfer A, Ziada J. et al. Hyalocytes in idiopathic epiretinal membranes: a correlative light and electron microscopic study. Graefes Arch Clin Exp Ophthalmol 2014; 252: 1887-1894 DOI: 10.1007/s00417-014-2841-x.
• 13 Kinoshita T, Kovacs KD, Wagley S. et al. Morphologic differences in epiretinal membranes on ocular coherence tomography as a predictive factor for surgical outcome. Retina 2011; 31: 1692-1698 DOI: 10.1097/IAE.0b013e31820f49d0.
• 14 Zhu XF, Peng JJ, Zou HD. et al. Prevalence and risk factors of idiopathic epiretinal membranes in Beixinjing blocks, Shanghai, China. PLoS One 2012; 7: e51445 DOI: 10.1371/journal.pone.0051445.
• 15 Byon IS, Pak GY, Kwon HJ. et al. Natural History of Idiopathic Epiretinal Membrane in Eyes with Good Vision Assessed by Spectral-Domain Optical Coherence Tomography. Ophthalmologica 2015; 234: 91-100 DOI: 10.1159/000437058.
• 16 Tanikawa A, Shimada Y, Horiguchi M. Comparison of visual acuity, metamorphopsia, and aniseikonia in patients with an idiopathic epiretinal membrane. Jpn J Ophthalmol 2018; 62: 280-285 DOI: 10.1007/s10384-018-0581-x.
• 17 Lee GW, Lee SE, Han SH. et al. Characteristics of secondary epiretinal membrane due to peripheral break. Sci Rep 2020; 10: 20881 DOI: 10.1038/s41598-020-78093-9.
• 18 Scheerlinck LM, van der Valk R, van Leeuwen R. Predictive factors for postoperative visual acuity in idiopathic epiretinal membrane: a systematic review. Acta Ophthalmol 2015; 93: 203-212 DOI: 10.1111/aos.12537.
• 19 Hubschman JP, Govetto A, Spaide RF. et al. Optical coherence tomography-based consensus definition for lamellar macular hole. Br J Ophthalmol 2020; 104: 1741-1747 DOI: 10.1136/bjophthalmol-2019-315432.
• 20 Govetto A, Lalane 3rd RA, Sarraf D. et al. Insights into Epiretinal Membranes: Presence of Ectopic Inner Foveal Layers and a New Optical Coherence Tomography Staging Scheme. Am J Ophthalmol 2017; 175: 99-113 DOI: 10.1016/j.ajo.2016.12.006.
• 21 Ortoli M, Blanco-Garavito R, Blautain B. et al. Prognostic factors of idiopathic epiretinal membrane surgery and evolution of alterations of the central cone bouquet. Graefes Arch Clin Exp Ophthalmol 2021; 259: 2139-2147 DOI: 10.1007/s00417-021-05110-6.
• 22 Jackson TL, Donachie PH, Williamson TH. et al. THE Royal College of Ophthalmologistsʼ National Ophthalmology Database Study of Vitreoretinal Surgery: Report 4, Epiretinal Membrane. Retina 2015; 35: 1615-1621 DOI: 10.1097/IAE.0000000000000523.
• 23 Yusuf AM, Bizrah M, Bunce C. et al. Surgery for idiopathic epiretinal membrane. Cochrane Database Syst Rev 2021; (03) CD013297 DOI: 10.1002/14651858.CD013297.pub2.
• 24 Bouwens MD, Van Meurs JC. Sine Amsler Charts: a new method for the follow-up of metamorphopsia in patients undergoing macular pucker surgery. Graefes Arch Clin Exp Ophthalmol 2003; 241: 89-93 DOI: 10.1007/s00417-002-0613-5.
• 25 Lee SM, Pak KY, Kwon HJ. et al. Association between Tangential Contraction and Early Vision Loss in Idiopathic Epiretinal Membrane. Retina 2018; 38: 541-549 DOI: 10.1097/IAE.0000000000001559.
• 26 Kim JH, Kim YM, Chung EJ. et al. Structural and functional predictors of visual outcome of epiretinal membrane surgery. Am J Ophthalmol 2012; 153: 103-110.e1 DOI: 10.1016/j.ajo.2011.06.021.
• 27 Miguel AI, Legris A. Prognostic factors of epiretinal membranes: A systematic review. J Fr Ophtalmol 2017; 40: 61-79 DOI: 10.1016/j.jfo.2016.12.001.
• 28 Shiono A, Kogo J, Klose G. et al. Photoreceptor outer segment length: a prognostic factor for idiopathic epiretinal membrane surgery. Ophthalmology 2013; 120: 788-794 DOI: 10.1016/j.ophtha.2012.09.044.
• 29 Shimozono M, Oishi A, Hata M. et al. The significance of cone outer segment tips as a prognostic factor in epiretinal membrane surgery. Am J Ophthalmol 2012; 153: 698-704 704.e1 DOI: 10.1016/j.ajo.2011.09.011.
• 30 Itoh Y, Inoue M, Rii T. et al. Correlation between foveal cone outer segment tips line and visual recovery after epiretinal membrane surgery. Invest Ophthalmol Vis Sci 2013; 54: 7302-7308 DOI: 10.1167/iovs.13-12702.
• 31 Park YG, Hong SY, Roh YJ. Novel Optical Coherence Tomography Parameters as Prognostic Factors for Stage 3 Epiretinal Membranes. J Ophthalmol 2020; 2020: 9861086 DOI: 10.1155/2020/9861086.
• 32 Inoue M, Morita S, Watanabe Y. et al. Preoperative inner segment/outer segment junction in spectral-domain optical coherence tomography as a prognostic factor in epiretinal membrane surgery. Retina 2011; 31: 1366-1372 DOI: 10.1097/IAE.0b013e318203c156.
• 33 Fernandes TF, Sousa K, Azevedo I. et al. Baseline visual acuity and interdigitation zone as predictors in idiopathic epiretinal membranes: A retrospective cohort study. Eur J Ophthalmol 2021; 31: 1291-1298 DOI: 10.1177/1120672120932094.
• 34 Jeon S, Jung B, Lee WK. Long-Term Prognostic Factors for Visual Improvement after Epiretinal Membrane Removal. Retina 2019; 39: 1786-1793 DOI: 10.1097/IAE.0000000000002211.
• 35 Ozdek S, Ozdemir Zeydanli E, Karabas L. et al. Relation of anatomy with function following the surgical treatment of idiopathic epiretinal membrane: a multicenter retrospective study. Graefes Arch Clin Exp Ophthalmol 2021; 259: 891-904 DOI: 10.1007/s00417-020-05002-1.
• 36 Zeyer JC, Parker P, Dajani O. et al. Preoperative Domed Macular Contour Correlates with Postoperative Visual Gain after Vitrectomy for Symptomatic Epiretinal Membrane. Retina 2021; 41: 505-509 DOI: 10.1097/IAE.0000000000002869.
• 37 Michalewski J, Michalewska Z, Cisiecki S. et al. Morphologically functional correlations of macular pathology connected with epiretinal membrane formation in spectral optical coherence tomography (SOCT). Graefes Arch Clin Exp Ophthalmol 2007; 245: 1623-1631 DOI: 10.1007/s00417-007-0579-4.
• 38 Gonzalez-Saldivar G, Berger A, Wong D. et al. Ectopic Inner Foveal Layer Classification Scheme Predicts Visual Outcomes after Epiretinal Membrane Surgery. Retina 2020; 40: 710-717 DOI: 10.1097/IAE.0000000000002486.
• 39 Zur D, Iglicki M, Feldinger L. et al. Disorganization of Retinal Inner Layers as a Biomarker for Idiopathic Epiretinal Membrane After Macular Surgery-The DREAM Study. Am J Ophthalmol 2018; 196: 129-135 DOI: 10.1016/j.ajo.2018.08.037.
• 40 Kim JH, Kang SW, Kong MG. et al. Assessment of retinal layers and visual rehabilitation after epiretinal membrane removal. Graefes Arch Clin Exp Ophthalmol 2013; 251: 1055-1064 DOI: 10.1007/s00417-012-2120-7.
• 41 Zou J, Tan W, Huang W. et al. Association between individual retinal layer thickness and visual acuity in patients with epiretinal membrane: a pilot study. PeerJ 2020; 8: e9481 DOI: 10.7717/peerj.9481.
• 42 Kinoshita T, Imaizumi H, Miyamoto H. et al. Two-year results of metamorphopsia, visual acuity, and optical coherence tomographic parameters after epiretinal membrane surgery. Graefes Arch Clin Exp Ophthalmol 2016; 254: 1041-1049 DOI: 10.1007/s00417-015-3147-3.
• 43 Hashimoto Y, Saito W, Saito M. et al. Retinal outer layer thickness increases after vitrectomy for epiretinal membrane, and visual improvement positively correlates with photoreceptor outer segment length. Graefes Arch Clin Exp Ophthalmol 2014; 252: 219-226 DOI: 10.1007/s00417-013-2432-2.
• 44 Govetto A, Bhavsar KV, Virgili G. et al. Tractional Abnormalities of the Central Foveal Bouquet in Epiretinal Membranes: Clinical Spectrum and Pathophysiological Perspectives. Am J Ophthalmol 2017; 184: 167-180 DOI: 10.1016/j.ajo.2017.10.011.
• 45 Brinkmann MP, Michels S, Brinkmann C. et al. Epiretinal membrane surgery outcome in eyes with abnormalities of the central bouquet. Int J Retina Vitreous 2021; 7: 7 DOI: 10.1186/s40942-020-00279-0.
• 46 Nam KY, Kim JY. Effect of internal limiting membrane peeling on the development of epiretinal membrane after pars plana vitrectomy for primary rhegmatogenous retinal detachment. Retina 2015; 35: 880-885 DOI: 10.1097/IAE.0000000000000421.
• 47 Aras C, Arici C, Akar S. et al. Peeling of internal limiting membrane during vitrectomy for complicated retinal detachment prevents epimacular membrane formation. Graefes Arch Clin Exp Ophthalmol 2009; 247: 619-623 DOI: 10.1007/s00417-008-1025-y.
• 48 Forlini M, Date P, Ferrari LM. et al. Comparative Analysis of Retinal Reattachment Surgery with or without Internal Limiting Membrane Peeling to Prevent Postoperative Macular Pucker. Retina 2018; 38: 1770-1776 DOI: 10.1097/IAE.0000000000001775.
• 49 Guillaubey A, Malvitte L, Lafontaine PO. et al. Incidence of retinal detachment after macular surgery: a retrospective study of 634 cases. Br J Ophthalmol 2007; 91: 1327-1330 DOI: 10.1136/bjo.2007.115162.
• 50 Chen JK, Khurana RN, Nguyen QD. et al. The incidence of endophthalmitis following transconjunctival sutureless 25- vs. 20-gauge vitrectomy. Eye (Lond) 2009; 23: 780-784 DOI: 10.1038/eye.2008.160.