More intravitreal injections, use of dexamethasone up risk of secondary ERM development

Dexamethasone implants and the number of intravitreal injections influence secondary epiretinal membrane (ERM) incidence after intravitreal injection, a recent study has found.

The study included 95 diabetic macular oedema patients (mean age, 59.7±12.7 years; 51.6 percent female) corresponding to 147 eyes eligible for analysis. Participants were treated with intravitreal injections and were then followed up for more than 24 months. ERM was defined as the presence of a highly reflective membrane at the vitreomacular interface upon optical coherence tomography testing.

Fourteen eyes developed secondary ERM over the course of the follow-up, with a mean time to formation of 19.3±12.4 months. The resulting incidence rate was 9.5 percent.

Analysis according to agent received, researchers found that 6.5 percent of eyes given antivascular endothelial growth factors and 7.1 percent of those that received triamcinolone developed secondary ERM. Notably, almost a quarter (24.0 percent) of the eyes that used dexamethasone developed secondary ERM. This was significantly greater than in injections (p=0.025).

The mean change in best-corrected visual acuity did not significantly differ between eyes that did vs did not develop secondary ERMs.

Multivariate logistic regression analysis confirmed the significant role of dexamethasone implants in increasing the likelihood of developing secondary ERM (odds ratio [OR], 1.02, 95 percent confidence interval [CI], 1.001–1.04; p=0.041). A greater number of intravitreal injections also emerged as a significant risk factor (OR, 1.212, 95 percent CI, 1.047–1.402; p=0.01).