ASSOCIATION BETWEEN EPIRETINAL MEMBRANE, EPIRETINAL PROLIFERATION, AND PROGNOSIS OF FULL-THICKNESS MACULAR HOLE CLOSURE.

PURPOSE: To demonstrate the effects of epiretinal membrane (ERM) and epiretinal proliferation (EP) on surgical outcomes for full-thickness macular hole (FTMH).

METHODS: Nested case-control study with propensity-score-matching. Patients operated on for FTMH between January 2011 and March 2020 were enrolled. The primary outcome was failure of the MH closure and the secondary outcome was unfavorable hole closure (V or λ type closure) at 6 months after the surgery.

RESULTS: 534 eyes of 534 patients met the inclusion criteria. After 1:1 propensity-score- matching (127 pairs), patients demonstrating ERM were more likely to have a failure of hole closure (adjusted odds ratio [aOR], 2.71; 95% CI 1.19-6.14) and unfavorable hole closure (aOR, 2.07; 95% CI, 1.16-3.71). ERM spanning the hole margin (hole marginal ERM, HM-ERM) greatly increased the likelihood of unfavorable hole closure (aOR, 2.13; 95% CI, 1.12-4.07). Patients with HM-ERM + EP were more likely to have a failure of hole closure (38.4%) compared to those with no ERM (11.8%).

CONCLUSION: Patients with ERM had a higher risk for adverse surgical outcomes for FTMH closure. The location of the ERM relative to the MH and the presence of EP might affect the surgical outcomes for FTMH closure.