Risk Factors Associated with Cystoid Macular Edema among Patients Undergoing Primary Repair of Rhegmatogenous Retinal Detachment

Yesha S Shah; Muhammad Abidi; Ishrat Ahmed; Lubaina T Arsiwala-Scheppach; Sally S Ong; David Wu; James T Handa

doi:10.1016/j.oret.2023.11.013

Risk Factors Associated with Cystoid Macular Edema among Patients Undergoing Primary Repair of Rhegmatogenous Retinal Detachment

Ophthalmol Retina. 2024 May;8(5):456-464. doi: 10.1016/j.oret.2023.11.013. Epub 2023 Nov 29.

Authors

Yesha S Shah¹, Muhammad Abidi¹, Ishrat Ahmed², Lubaina T Arsiwala-Scheppach³, Sally S Ong⁴, David Wu², James T Handa⁵

Affiliations

¹ Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland.
² Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland; Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts.
³ Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland; Wilmer Biostatistics Center, Johns Hopkins School of Medicine, Baltimore, Maryland.
⁴ Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland; Department of Ophthalmology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
⁵ Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland. Electronic address: jthanda@jhmi.edu.

PMID: 38036083
PMCID: PMC11070291 (available on 2025-05-01)
DOI: 10.1016/j.oret.2023.11.013

Abstract

Purpose: To investigate predictors of the development and resolution of cystoid macular edema (CME) after rhegmatogenous retinal detachment (RRD) repair.

Design: Retrospective cross sectional study.

Subjects: Patients who underwent primary repair of uncomplicated RRD.

Methods: Demographics, ophthalmic history, visual acuity, RRD features, time to development/resolution of CME, OCT characteristics of CME/epiretinal membrane (ERM), type of surgery, and treatments were collected. Logistic regressions were used to identify predictors of CME development and resolution.

Main outcome measures: Predictors of CME development and resolution.

Results: A total of 708 eyes were included, of which 55 (7.8%) developed CME. Factors associated with an increased risk of CME development included total number of retinal detachment surgeries (odds ratio [OR] 1.66 [1.24-2.23], P < 0.001), prior intraocular surgery (OR 4.43 [1.19-16.51], P = 0.03), and presence of ERM after surgery (OR 4.49 [2.30-8.74], P < 0.001). Patients undergoing pars plana vitrectomy (PPV) were more likely to develop CME compared with patients undergoing scleral buckling (SB; OR 3.09 [1.18-8.10], P = 0.02). A longer average time to CME detection was associated with lower CME resolution (OR 0.94 [0.89-0.998], P = 0.04). In patients who developed an ERM postsurgically, those who developed CME after ERM had a lower rate of resolution compared with those who developed CME before ERM (P = 0.03).

Conclusions: Cystoid macular edema may be more likely to develop in patients undergoing PPV than SB, those who underwent more surgeries for RRD repair, those who had prior intraocular surgery, or those who developed an ERM after RRD repair. Resolution of CME may be affected by the time to detection of CME and ERM development.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: Cystoid macular edema; Epiretinal membrane; Rhegmatogenous retinal detachment; Risk factors.

MeSH terms

Aged
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Macular Edema* / diagnosis
Macular Edema* / etiology
Male
Middle Aged
Postoperative Complications / epidemiology
Retinal Detachment* / diagnosis
Retinal Detachment* / etiology
Retinal Detachment* / surgery
Retrospective Studies
Risk Factors
Scleral Buckling / adverse effects
Scleral Buckling / methods
Tomography, Optical Coherence* / methods
Visual Acuity*
Vitrectomy* / adverse effects
Vitrectomy* / methods

Grants and funding

P30 EY001765/EY/NEI NIH HHS/United States