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Purpose <p>To evaluate the retinal and choroidal parameters associated with long-term postoperative visual outcomes of surgery for stage 3 and 4 epiretinal membranes (ERMs) and determine whether intravitreal or periocular steroid injection within the first operative year is independently associated with long-term visual improvement.</p> Methods <p>This single-center retrospective cohort study included patients diagnosed with stage 3 and 4 ERM who underwent pars plana vitrectomy between January 2019 and December 2022. The follow-up duration exceeded 2 years. The retinal and choroidal parameters were measured using optical coherence tomography. Their preoperative and postoperative best-corrected visual acuities (BCVA) were also measured, and independent predictors were evaluated using multivariable linear regression models.</p> Results <p>The data of 96 and 31 eyes with stage 3 and stage 4 ERM, respectively, were included. Preoperative BCVA was the strongest independent predictor of visual outcome across all time points (<i>p</i> &lt; 0.001). The ellipsoid zone integrity and intraretinal cystic change showed borderline associations with postoperative BCVA at 3 months (<i>p</i> = 0.052) and 1 year (<i>p</i> = 0.079), respectively. At 2 years, the adjusted mean BCVA improvement (ΔlogMAR) was 0.146 (95% CI, 0.059–0.232) in the no-injection group and 0.203 (95% CI, 0.029–0.377) in the injection group. The adjusted between-group difference was 0.058 logMAR (95% CI, -0.141-0.256; <i>p</i> = 0.558) indicating no statistically significant association.</p> Conclusion <p>This study provides longitudinal evidence that preoperative VA and postoperative EZ and retinal cystic changes are key indicators of 2-year visual outcomes after ERM surgery. However, choroidal thickness and postoperative steroid injection are not independently associated with these outcomes. These findings support the use of baseline vision and retinal microstructural status for preoperative counseling and risk stratification.</p> <p>Due to the retrospective nature of the study, the clinical trial number: not applicable.</p>

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Predictors of two-year visual outcomes after surgery for stage 3–4 epiretinal membrane: role of baseline vision and early retinal microstructural recovery

  • 期刊论文

  • 发表日期：

    2026年4月11日

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  • Ji Hye Lee,
  • Young Gun Park,
  • Young-Hoon Park

摘要

Purpose

To evaluate the retinal and choroidal parameters associated with long-term postoperative visual outcomes of surgery for stage 3 and 4 epiretinal membranes (ERMs) and determine whether intravitreal or periocular steroid injection within the first operative year is independently associated with long-term visual improvement.

Methods

This single-center retrospective cohort study included patients diagnosed with stage 3 and 4 ERM who underwent pars plana vitrectomy between January 2019 and December 2022. The follow-up duration exceeded 2 years. The retinal and choroidal parameters were measured using optical coherence tomography. Their preoperative and postoperative best-corrected visual acuities (BCVA) were also measured, and independent predictors were evaluated using multivariable linear regression models.

Results

The data of 96 and 31 eyes with stage 3 and stage 4 ERM, respectively, were included. Preoperative BCVA was the strongest independent predictor of visual outcome across all time points (p < 0.001). The ellipsoid zone integrity and intraretinal cystic change showed borderline associations with postoperative BCVA at 3 months (p = 0.052) and 1 year (p = 0.079), respectively. At 2 years, the adjusted mean BCVA improvement (ΔlogMAR) was 0.146 (95% CI, 0.059–0.232) in the no-injection group and 0.203 (95% CI, 0.029–0.377) in the injection group. The adjusted between-group difference was 0.058 logMAR (95% CI, -0.141-0.256; p = 0.558) indicating no statistically significant association.

Conclusion

This study provides longitudinal evidence that preoperative VA and postoperative EZ and retinal cystic changes are key indicators of 2-year visual outcomes after ERM surgery. However, choroidal thickness and postoperative steroid injection are not independently associated with these outcomes. These findings support the use of baseline vision and retinal microstructural status for preoperative counseling and risk stratification.

Due to the retrospective nature of the study, the clinical trial number: not applicable.