Purpose: The purpose of this study was to determine the prevalence and imaging characteristics of thin and thick idiopathic epiretinal membranes (ERMs) using high-resolution (HR) optical coherence tomography (OCT) and to identify clinical factors associated with ERM thickness phenotype. Methods: All patients underwent comprehensive ophthalmologic examination and multimodal imaging, including HR-OCT. ERM morphology was evaluated on fovea-centered OCT scans and classified as thin or thick based on preretinal reflectivity patterns. Multivariable generalized estimating equations (GEEs) were used to identify factors independently associated with ERM type while accounting for inter-eye correlation. Results: Fifty-four eyes included in this analysis and 28 (51.9%) were classified as thin ERM, whereas 26 (48.1%) were thick ERM. Patients with thick ERM were significantly older than those with thin ERM (81.6 ± 6.2 vs. 75.7 ± 10.8 years, P = 0.039). Pseudophakia was more prevalent in the thick ERM group (84.6% vs. 60.7%, P 0.05). In multivariable analysis, pseudophakia (odds ratio OR = 10.33, 95% confidence interval CI = 1.29-83.10, P = 0.028) and age-related macular degeneration (AMD; OR = 4.12, 95% CI = 1.01-16.87, P = 0.049) were independently associated with thick ERM. Conclusions: HR-OCT enables in vivo differentiation of thin and thick idiopathic ERMs. Thick ERM is independently associated with pseudophakia and AMD but not with greater CMT or worse BCVA, suggesting that ERM thickness phenotype may reflect differences in factors other than vitreoretinal interface biology alone.
An et al. (Thu,) studied this question.