Work

Macular epiretinal membrane in high myopia: timing and prognosis of pars plana vitrectomy surgery

Year: 2025

Type: article

Abstract: AIM: To investigate the outcomes and prognosis of macular epiretinal membrane (ERM) after pars plana vitrectomy (PPV) in patients with high myopia (HM), focusing on the optimal timing of surgery and its impact on prognosis. METHODS: The clinical data of 50 eyes from 49 patients diagnosed with ERM, who were highly myopic and underwent PPV were retrospectively analyzed. The patients with ERM were classified into five groups based on the characteristics associated with different levels of myopic traction maculopathy. Group 1: Simple ERM without complex vertical and tangential direction traction on retina on optical coherence tomography (OCT) image; Group 2: ERM with obvious macular foveal schisis, without macular hole (MH); Group 3: ERM with inner lamellar MH, with or without macular foveal schisis; Group 4: ERM with outer lamellar MH, with or without foveal retinal detachment (RD); Group 5: ERM with full-thickness MH. Baseline characteristics, changes in best corrected visual acuity (BCVA) before and after surgery, and anatomical characteristics through spectral domain OCT were compared. RESULTS: >0.05). OCT showed that Groups 4 and 5 exhibited poorer macular anatomy compared to the other three groups, as evidenced by lower rates of central retinal reattachment (64.3% in Group 4, 86.7% in Group 5) and integrity of the inner segment/outer segment of photoreceptor junction (28.6% in Group 4, 26.7% in Group 5). CONCLUSION: PPV is an effective treatment for ERM in patients with HM. All groups showed postoperative improvement in BCVA compared to preoperative levels, demonstrating the necessity of surgical intervention. Early intervention, particularly before the fourth stage of the disease, may lead to better visual outcomes.

Source: International Journal of Ophthalmology

DOI: 10.18240/ijo.2025.09.10