Li Feng, Hinkle David M, Finger Paul T
Department of Ocular Tumor, Orbital Disease, and Ophthalmic Radiation Therapy, The New York Eye Cancer Center, New York, NY, USA.
Department of Ophthalmology, Tulane University School of Medicine, New Orleans, LA, USA.
J Vitreoretin Dis. 2025 May 22:24741264251336334. doi: 10.1177/24741264251336334.
To describe the prevalence of epiretinal membrane (ERM) in eyes with choroidal melanoma. A retrospective clinical case review was conducted to evaluate the prevalence of ERMs. Examinations included ophthalmoscopy, fundus photography, and optical coherence tomography. Multivariate analysis evaluated ERMs with choroidal melanoma, retinal detachment (RD) before treatment, plaque radiation dose to the fovea, radiation retinopathy, and intravitreal (IVT) antivascular endothelial growth factor (anti-VEGF) treatment. Contralateral eyes were used as controls. The study included 373 patients (746 eyes). ERMs were found in 34% of eyes with choroidal melanoma that were treated and 12.1% of control eyes. A larger tumor size (increasing American Joint Committee on Cancer cT category) was significantly associated with the presence of an ERM at baseline. In addition, a higher radiation dose to the fovea was associated with ERM development. Risk factors determined by multivariate analysis included radiation retinopathy (odds ratio [OR], 3.00), anti-VEGF injections (OR, 2.87), and RD at presentation (OR, 3.19). This study found a significantly higher prevalence of ERMs in eyes with choroidal melanoma. Risk factors contributing to ERM development included the radiation dose, radiation retinopathy, IVT anti-VEGF injections, and RD. Of these factors, the presence of RD at the initial diagnosis was the strongest predictor of the occurrence of a secondary ERM.
描述脉络膜黑色素瘤患者视网膜前膜（ERM）的患病率。进行了一项回顾性临床病例分析以评估ERM的患病率。检查包括检眼镜检查、眼底照相和光学相干断层扫描。多变量分析评估了脉络膜黑色素瘤患者的ERM、治疗前的视网膜脱离（RD）、黄斑区的斑块放射剂量、放射性视网膜病变以及玻璃体内（IVT）抗血管内皮生长因子（抗VEGF）治疗情况。对侧眼用作对照。该研究纳入了373例患者（746只眼）。在接受治疗的脉络膜黑色素瘤患者中，34%的患眼发现有ERM，而对照眼中这一比例为12.1%。更大的肿瘤大小（美国癌症联合委员会cT分类增加）与基线时存在ERM显著相关。此外，黄斑区更高的放射剂量与ERM的发生有关。多变量分析确定的危险因素包括放射性视网膜病变（比值比[OR]，3.00）、抗VEGF注射（OR，2.87）以及就诊时的RD（OR，3.19）。本研究发现脉络膜黑色素瘤患者中ERM的患病率显著更高。导致ERM发生的危险因素包括放射剂量、放射性视网膜病变、IVT抗VEGF注射以及RD。在这些因素中，初始诊断时存在RD是继发性ERM发生的最强预测因素。
