Epiretinal Membrane Is Associated with Diabetic Retinopathy Severity and Cumulative Anti-VEGF Injections

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-02-07 DOI:10.1016/j.xops.2025.100733

Shinji Kakihara MD, PhD, Mohamed AbdelSalam, Kallista Zhuang BS, Amani A. Fawzi MD

{"title":"Epiretinal Membrane Is Associated with Diabetic Retinopathy Severity and Cumulative Anti-VEGF Injections","authors":"Shinji Kakihara MD, PhD, Mohamed AbdelSalam, Kallista Zhuang BS, Amani A. Fawzi MD","doi":"10.1016/j.xops.2025.100733","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To identify and assess the risk factors for epiretinal membrane (ERM) formation in patients with diabetes mellitus (DM).</div></div><div><h3>Design</h3><div>A cross-sectional observational study.</div></div><div><h3>Participants</h3><div>Diabetes mellitus subjects with varying severities of diabetic retinopathy (DR).</div></div><div><h3>Methods</h3><div>Epiretinal membrane severity was graded using OCT macular volumetric scans. After comparing the features of eyes with and without ERM, a logistic regression model was employed to investigate risk factors for the presence of ERM formation, with explanatory variables that were statistically significant between 2 groups.</div></div><div><h3>Main Outcome Measures</h3><div>The risk factors for ERM formation and their odds ratios.</div></div><div><h3>Results</h3><div>The study analyzed 207 eyes of 207 patients without center-involving diabetic macular edema, including 44 with DM but no DR, 23 with mild DR, 42 with moderate DR, 28 with severe nonproliferative DR, and 70 with proliferative DR. Among these, 49 eyes had ERM. Eyes with ERM demonstrated significantly higher DR severity, more frequent history of cataract surgery, a greater number of anti-VEGF injections, less frequent hypertension, and higher geometric perfusion deficits in the deep capillary plexus, as calculated by OCT angiography, compared to eyes without ERM. After adjusting for explanatory variables, the logistic regression model identified DR severity and the number of injections as significant risk factors for ERM formation. The adjusted odds ratios were 2.388 (95% confidence interval [CI]: 1.694–3.566, <em>P</em> < 0.0001) for DR severity and 1.196 (95% CI: 1.013–1.444, <em>P</em> = 0.0449) for the number of injections, respectively.</div></div><div><h3>Conclusions</h3><div>In this cross-sectional study, DR severity as well as the number of anti-VEGF injections were identified as significant risk factors for ERM formation.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 3","pages":"Article 100733"},"PeriodicalIF":3.2000,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology science","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666914525000314","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To identify and assess the risk factors for epiretinal membrane (ERM) formation in patients with diabetes mellitus (DM).

Design

A cross-sectional observational study.

Participants

Diabetes mellitus subjects with varying severities of diabetic retinopathy (DR).

Methods

Epiretinal membrane severity was graded using OCT macular volumetric scans. After comparing the features of eyes with and without ERM, a logistic regression model was employed to investigate risk factors for the presence of ERM formation, with explanatory variables that were statistically significant between 2 groups.

Main Outcome Measures

The risk factors for ERM formation and their odds ratios.

Results

The study analyzed 207 eyes of 207 patients without center-involving diabetic macular edema, including 44 with DM but no DR, 23 with mild DR, 42 with moderate DR, 28 with severe nonproliferative DR, and 70 with proliferative DR. Among these, 49 eyes had ERM. Eyes with ERM demonstrated significantly higher DR severity, more frequent history of cataract surgery, a greater number of anti-VEGF injections, less frequent hypertension, and higher geometric perfusion deficits in the deep capillary plexus, as calculated by OCT angiography, compared to eyes without ERM. After adjusting for explanatory variables, the logistic regression model identified DR severity and the number of injections as significant risk factors for ERM formation. The adjusted odds ratios were 2.388 (95% confidence interval [CI]: 1.694–3.566, P < 0.0001) for DR severity and 1.196 (95% CI: 1.013–1.444, P = 0.0449) for the number of injections, respectively.

Conclusions

In this cross-sectional study, DR severity as well as the number of anti-VEGF injections were identified as significant risk factors for ERM formation.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

查看原文本刊更多论文

视网膜前膜与糖尿病视网膜病变严重程度和累积抗vegf注射相关

目的探讨糖尿病（DM）患者视网膜前膜（ERM）形成的危险因素。设计横断面观察性研究。受试者：患有不同程度糖尿病视网膜病变（DR）的糖尿病患者。方法采用OCT黄斑体积扫描对视网膜膜严重程度进行分级。比较有无ERM的眼睛特征，采用logistic回归模型探讨ERM形成的危险因素，解释变量两组间差异均有统计学意义。主要结局指标ERM形成的危险因素及其优势比。结果本研究对207例无中心累及性糖尿病黄斑水肿患者的207只眼进行了分析，其中糖尿病无DR 44只，轻度DR 23只，中度DR 42只，重度非增殖性DR 28只，增殖性DR 70只。与没有ERM的眼睛相比，有ERM的眼睛表现出明显更高的DR严重程度，更频繁的白内障手术史，更多的抗vegf注射，更少的高血压，更大的深毛细血管丛几何灌注缺陷，通过OCT血管造影计算。在调整解释变量后，逻辑回归模型确定DR严重程度和注射次数是ERM形成的重要危险因素。校正后的优势比为2.388(95%可信区间[CI]: 1.694-3.566, P <；DR严重程度为0.0001)，注射次数为1.196 （95% CI: 1.013-1.444, P = 0.0449）。结论在本横断面研究中，DR严重程度和抗vegf注射次数被确定为ERM形成的重要危险因素。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊