Epiretinal membrane development may be linked with systemic hypertension, disc hemorrhage, autonomic imbalance, and higher baseline and peak intraocular pressure (IOP) in individuals with glaucoma, according to a study published in the American Journal of Ophthalmology.
Researchers enrolled 192 participants (baseline age, 57.25 years; 42.7% men) from the Catholic Medical Center Glaucoma Suspect Cohort Study in the multicenter case control study, which included participants with epiretinal membrane (n=64) and individuals with glaucoma and no epiretinal membrane (n=128) who were selected using propensity score matching (1:2). Participants underwent IOP evaluation, which included measurements of baseline IOP, mean IOP, and IOP fluctuation in addition to fundus photography, optical coherence tomography (OCT), and visual field (VF) assessments.
The investigators performed disc and fundus photography at 1 to 3 month follow-up intervals and VF and OCT examination at 6-month intervals during the study duration. The study’s objective was to identify factors associated with epiretinal membrane development.
Epiretinal membrane development was associated with older age (P =.048), taking medication for systemic hypertension (P <.001), IOP fluctuation (P <.001), presence of disc hemorrhage (P <.001), and worse VF mean deviation (P =.033), the report shows. Participants with early glaucoma who developed epiretinal membrane were more prone to a higher rate of autonomic imbalance, while individuals with moderate-to-advanced glaucoma with epiretinal membrane were more likely to have a higher baseline and peak IOP and worse VF mean deviation (<6.0 dB) at their last follow-up.
“The development of [epiretinal membrane] in glaucoma patients could be used as a clinical marker indicating the need to monitor patients in terms of IOP fluctuation, vascular factors, and glaucoma progression,” according to the study authors.
Study limitations include an inability to measure IOP changes outside of office hours and failure to consider the number of glaucoma drops or hypertension medications taken by participants.
Shin DY, Park H-YL, Shin H, et al. Fluctuation of intraocular pressure and vascular factors are associated with the development of epiretinal membrane in glaucoma. Am J Ophthalmol. Published online June 14, 2023. doi:10.1016/j.ajo.2023.06.001