Idiopathic epiretinal membrane area changes in eyes with good vision and the association with visual function

Abstract

Purpose To evaluate idiopathic epiretinal membrane (iERM) area changes and the association with visual function in patients with good vision, using confocal scanning laser ophthalmoscopy (cSLO). Methods The medical records of patients with iERM with best-corrected visual acuity (BCVA) ≥ 20/25 and a follow-up period ≥ 2 years were reviewed retrospectively. BCVA, metamorphopsia, fundus images using cSLO, and optical coherence tomography images were obtained at baseline and every 6 months. The ERM area and diagonal lengths of the long and short axes were determined. The progression group was defined as eyes with ≥2 lines of loss, and the stable group was defined as eyes with less change. Results This study included 46 eyes, with 23 eyes in each group. Participants in the progression group were younger (60.7 vs. 65.7 years, P = 0.015) and showed a larger BCVA change (0.20 vs. 0.04, P < 0.001) and greater ERM area decrease (34.2% vs. 11.7%, P < 0.001) during the follow-up period. In the progression group, BCVA reduction was correlated with area decrease (β = 0.571, P = 0.010). No factors were associated with metamorphopsia. In the univariate analysis, ERM area reduction at 6 months was a significant predictor of vision loss (odds ratio, 1.632; P = 0.002). Receiver operating characteristic analysis identified a 7.66% ERM area reduction at 6 months as the optimal cutoff for predicting vision loss (81.8% sensitivity, 82.6% specificity). Conclusions ERM area reduction significantly correlates with vision loss in patients with iERM with good vision. Monitoring ERM area changes can help predict disease progression and visual outcomes.