Clinical characteristics and surgical outcomes of pediatric idiopathic and secondary macular epiretinal membrane

Abstract

Abstract Background: To describe and compare the different clinical characteristics and surgical outcomes of patients with pediatric idiopathic and secondary macular epiretinal membranes (ERMs). Methods: A cohort of pediatric patients (≤14years) underwent surgical removal of macular ERMs were selected from January 2019 to September 2021. Those patients were grouped into idiopathic macular ERMs group and secondary macular ERMs group, medical data including ocular manifestations were assessed and compared preoperatively and postoperatively. Results :A total of 41 patients (50 eyes) were included, mean age at surgery was 6.5 years (3～14 years), mean follow-up duration was 19.5months (12～31 months). Fourteen of the 41 patients (34.1%) had idiopathic macular ERMs. Compared with secondary macular ERMs, pediatric idiopathic ERMs had an older age at surgery(p=0.032) and were mostly found fortuitously by school visual acuity (VA) screening(p=0.028) with more cases with appearance of cellophane macular reflex (p=0.047); on OCT images, idiopathic macular ERMs were more likely to have taco folds (p=0.031)and less ellipsoid zone (EZ) disruptions (p=0.026) ; idiopathic macular ERMs were more likely to have better preoperative best corrected visual acuity (BCVA)(p<0.001); surgical removal of pediatric macular ERMs results in VA improvement with less postoperative complications in pediatric idiopathic ERMs. Conclusion: Pediatric idiopathic macular ERMs have many different clinical characteristics compared with that of pediatric secondary macular ERMs; surgical removal of pediatric macular ERMs results in VA improvement with less postoperative complications in pediatric idiopathic ERMs. Trial registration: Retrospective case series study, not applicable. NCT2378898