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Microcystic Macular Edema and Cystoid Macular Edema Before and After Epiretinal Membrane Surgery.

PURPOSE
To investigate the types of intraretinal cysts (IRCs) that are associated with epiretinal membranes (ERMs) and to evaluate the effects of each type of IRC on postoperative outcomes.


METHODS
Retrospective, cross-sectional study design. Patients who underwent preoperative fluorescent angiography and ERM surgery from February 2014 to May 2019 were included. IRCs were subdivided into cystoid macular edema (CME) with angiographic leakage and microcystic macular edema (MME) without angiographic leakage.


RESULTS
A total of 100 eyes from 100 patients was enrolled. IRCs were present in 54 (54.0%) eyes before surgery, of which 27 (27.0%) eyes showed MME, 18 (18.0%) eyes showed CME, and 9 (9.0%) eyes showed CME and MME. After surgery, the number of eyes with CME decreased significantly (p<0.001), while the number of eyes with MME did not (p=0.302). Absence of preoperative MME, poorer initial visual acuity, increased central foveal thickness, and intact ellipsoidal zone were associated with favorable visual recovery (p=0.035, 0.033, 0.018, and 0.035, respectively).


CONCLUSION
MME associated with ERM was a poor prognostic factor for ERM surgery. The persistent existence of MME after surgery affirms related chronic structural changes. Further studies should investigate whether earlier surgical intervention (possibly before the development of MME) benefits visual outcomes.