Epiretinal Membrane Removal May Reduce Injection Burden in nAMD

Clinical Report: Epiretinal Membrane Removal May Reduce Injection Burden in nAMD

Overview

In a small retrospective study, the removal of epiretinal membranes (ERM) in patients with neovascular age-related macular degeneration (nAMD) was associated with a reduction in the burden of anti-VEGF injections. Two-thirds of patients either stopped or reduced their injection frequency following surgery.

Background

Neovascular age-related macular degeneration (nAMD) is a leading cause of vision loss, and anti-VEGF injections are the standard treatment. However, some patients experience persistent cystoid macular edema despite therapy, necessitating alternative interventions. Understanding the impact of surgical options like ERM removal on treatment burden is crucial for optimizing patient care.

Data Highlights

Parameter	Before Surgery	After Surgery	P-Value
Mean number of injections	7.58	4.33	0.009
Central retinal thickness (μm)	328	288	0.092

Key Findings

Two-thirds of patients stopped or reduced anti-VEGF injections after ERM removal.
Mean number of injections decreased from 7.58 to 4.33 post-surgery (P=0.009).
Four patients completely stopped injections, while four others had a reduced injection burden.
Mean time to resumption of injections among those who resumed was 16.4 weeks.
Central retinal thickness decreased from approximately 328 μm to 288 μm, though not statistically significant (P=0.092).
Visual acuity did not change significantly post-surgery (P=0.081).

Clinical Implications

The findings suggest that surgical intervention for ERM in patients with treatment-resistant nAMD may lead to a reduced need for anti-VEGF injections. This could potentially alleviate the treatment burden for patients who are struggling with persistent edema despite ongoing therapy.

Conclusion

The study indicates that ERM removal may be a beneficial surgical option for patients with nAMD, leading to a significant reduction in anti-VEGF injection frequency. Further research is warranted to confirm these findings.