Epiretinal Membrane Appearance or Progression After Intravitreal Injection in Age-Related Macular Degeneration
Abstract Background: To evaluate the influence of anti-vascular endothelial growth factor (VEGF) in the appearance or progression of epiretinal membranes (ERMs) in age-related macular degeneration (ARMD) and investigate determining factors.Methods: Seventy-six eyes that were treated for more than 36 months from the first anti-VEGF injection were assessed. Binary logistic regression analysis was performed between smoking, lens status, subretinal hemorrhage, posterior vitreous detachment (PVD) status, peripheral degeneration, contralateral eye, and the number of injections as independent variables and appearance or progression of ERMs during 36 months as dependent variables.Results: The presence of vitreous macular adhesion (VMA) or development of PVD during the observation period was significantly associated (Odds ratio [OR]: 5.76; 95% confidence limit [CL], 1.72-19.3; p=0.005) with the appearance or progression of ERMs. Moreover, peripheral retinal degeneration was significantly associated (OR: 3.85; 95% CL, 1.15-13.0; p=0.029). Injection number of anti-VEGF was not significantly associated (OR: 1.02; 95% CL, 0.90-1.16; p=0.73). Number of anti-VEGF injections in ARMD had little relationship with developing secondary ERMs. VMA or developing PVD and peripheral degenerations had an association with developing ERMs. Conclusion: This study suggests possibilities that anti-VEGF injections alone are unable to cause the development of ERMs, that the vitreoretinal interface has a prior impact on the developing ERMs in ARMD similar to that of idiopathic ERMs, and that peripheral degenerations co-exist with or are evoked by vitreoretinal adhesion in the pathogenesis of ARMD, both being related to ERMs development.