Association Between Retinal Vein Occlusion and Epiretinal Membrane Development.

Abstract

To evaluate the temporal association between retinal vein occlusion (RVO) and the development of epiretinal membrane (ERM) including subsequent ERM peel. Retrospective cohort study. After propensity score matching (PSM) and applying inclusion/exclusion criteria, 19,172 patients with branch retinal vein occlusion (BRVO) and 14,974 with central retinal vein occlusion (CRVO) were compared with matched controls. Data was extracted using a national clinical database. Patients with BRVO or CRVO were compared with individuals without RVO (control) for the development of main outcomes measures. Secondary analyses examined RVO cohorts with anti-VEGF injections: BRVO-T (anti-VEGF-treated) and CRVO-T versus their respective untreated counterparts. Relative risk (RR) of incident ERM formation and ERM peel at multiple time points from 3 months to 5 years. During the 5-year study period, BRVO and CRVO cohorts had the highest risk for ERM formation at 3 months compared with their respective controls (BRVO: RR = 4.54; CRVO: RR = 4.90; P < .0001). The risk of ERM peel was greatest at one year for BRVO (RR, 3.83; P < .0001) and 3 years for CRVO (RR, 3.91; P < .0001). In the secondary analysis, anti-VEGF treatment was associated with higher ERM rates at 3 months in BRVO-T (RR, 5.60; P < .0001) and CRVO-T (RR, 6.80; P < .0001) cohorts. The incidence of ERM peel peaked later in treated eyes at 5 years (BRVO-T: RR, 3.30; P = .0004; CRVO-T: RR, 2.60; P = .0075) compared with untreated eyes. ERM formation typically occurs during the first 3 months following RVO, while surgical intervention peaks later, as early as one year in untreated eyes, and 5 years in eyes treated with anti-VEGF agents. Treated patients also exhibited an elevated risk for ERM development, which could be influenced by differences in baseline disease severity rather than a clear treatment effect.