Microvascular Leakage as an Irreversible Poor Prognostic Factor in Idiopathic Epiretinal Membrane Surgery

Purpose: To assess changes in microvascular leakage (ML) and their association with clinical outcomes in idiopathic epiretinal membrane (iERM) surgery.Methods: We included iERM eyes with at least 6 months of follow-up after surgery.Optical coherence tomography (OCT) and fluorescein angiography (FA) were performed at baseline and 6 months.Best-corrected visual acuity (BCVA) and structural changes on OCT, including central subfield macular thickness (CSMT), intraretinal cystic lesion (IRC), ectopic inner foveal layer, disorganization of retinal inner layers, and ML were assessed.The main outcome measures were changes in ML and their association with BCVA and OCT parameters.Results: Among 37 eyes, 21 (56.8%)showed ML at baseline, and this persisted in all eyes after surgery.Of the 16 eyes without ML, four developed ML postoperatively.IRC resolved in four eyes and newly developed in one.The new ML was not associated with new IRCs or poor BCVA.In eyes with baseline ML, IRC disappeared in four eyes and developed in three.Eyes with baseline ML exhibited worse BCVA and thicker CSMT postoperatively.Conclusions: Baseline ML persisted even after successful iERM removal.New ML developed in some eyes but did not influence changes in IRC and BCVA.Baseline ML can be used as an irreversible poor prognostic factor in iERM patients.