This study linked pseudoexfoliative glaucoma and epiretinal membrane deterioration. Photo: Stephen Obstbaum, MD, Diana Shechtman, OD.  Click image to enlarge.

Building from previous research, investigators initiated a recent study to examine the longitudinal changes in epiretinal membranes (ERMs) and their association with glaucoma among patients with pseudoexfoliation syndrome. Findings showed that deterioration of the epiretinal membrane occurred more often in pseudoexfoliation syndrome eyes with glaucoma when compared with those without the disease.

This retrospective analysis included 102 eyes with pseudoexfoliative glaucoma and 32 eyes with non-glaucomatous pseudoexfoliation. The presence and staging of ERMs (stages one, two and ≥three) on serial macular OCT images were independently assessed by a glaucoma specialist and retina specialist.

Among the eyes with pseudoexfoliative glaucoma, 22 (21.6%) had an ERM at baseline. Six of those eyes deteriorated from stage one to two. Of the 80 glaucomatous eyes without ERM at baseline, three developed new membranes during follow-up, according to the study authors.

Data showed that eight of the 32 eyes with non-glaucomatous pseudoexfoliation had an epiretinal membrane at baseline and none changed over time. The researchers reported that the presence of glaucoma was marginally associated with ERM deterioration. Additionally, they found that the only factor associated with visual field progression in pseudoexfoliative glaucoma eyes was incremental change in central macular thickness.

This research demonstrated that a greater proportion of eyes with pseudoexfoliative glaucoma had ERM progression compared with eyes without glaucomatous change, according to the study authors. They concluded, “The increased central macular thickness based on epiretinal membrane progression affected visual function, which may not be related to glaucomatous damage, but should be considered in care of patients with pseudoexfoliation glaucoma. These findings may advance understanding of the mechanism of neurodegeneration in eyes with pseudoexfoliation glaucoma.”

Lee JY, Sung KR, Kim YJ. Association of epiretinal membrane with pseudoexfoliation glaucoma and long-term factors affecting visual function. J Glaucoma. March 29, 2022. [Epub ahead of print].