Association of intravitreal and topical anti-inflammatory therapies on short-term anatomical and functional outcomes following epiretinal membrane surgery

Pinja Sutinen; Idan Hecht; Minna Karesvuo; Sohee Jeon; Petteri Karesvuo; Raimo Tuuminen

doi:10.1111/aos.17430

Association of intravitreal and topical anti-inflammatory therapies on short-term anatomical and functional outcomes following epiretinal membrane surgery

Acta Ophthalmol. 2024 Dec 20. doi: 10.1111/aos.17430. Online ahead of print.

Authors

Pinja Sutinen¹, Idan Hecht^{1

2

3}, Minna Karesvuo^{1

4}, Sohee Jeon⁵, Petteri Karesvuo^{1

6}, Raimo Tuuminen^{1

7}

Affiliations

¹ Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland.
² Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
³ Department of Ophthalmology, Shamir Medical Center, Tel Aviv, Israel.
⁴ Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.
⁵ Vitreoretinal Service, Keye Eye Center, Seoul, South Korea.
⁶ Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland.
⁷ Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland.

PMID: 39707151
DOI: 10.1111/aos.17430

Abstract

Purpose: Here we examine the association of anti-inflammatory therapy with anatomical and functional outcomes of epiretinal membrane surgery.

Methods: The study included consecutive patients having gone through epiretinal membrane surgery at Helsinki University Hospital, Finland, between 2017 and 2021. The association of perioperative intravitreal and postoperative topical anti-inflammatory therapies with surgical outcomes was assessed.

Results: In total, 214 eyes of 214 patients with a mean age of 71.2 ± 8.2 years were studied. At 1-month, perioperative intravitreal use of triamcinolone acetonide (n = 27) was associated with a significant proportional and absolute improvement in foveal thickness (-15.9 ± 18.4% vs. -4.2 ± 25.6%, p = 0.003 and -86.2 ± 109.6 μm vs. -33.7 ± 94.3 μm, p = 0.004), and central subfield macular thickness (-14.7 ± 16.5% vs. -6.3 ± 16.9%, p = 0.009 and -80.6 ± 102.8 μm vs. -36.1 ± 75.9 μm, p = 0.004) when compared to those without triamcinolone acetonide. Furthermore, best-corrected visual acuity (BCVA) gain showed a non-significant yet corresponding trend favouring intraoperative intravitreal use of triamcinolone acetonide (0.21 ± 0.27 vs. 0.09 ± 0.28 LogMAR units, p = 0.062). Postoperative use of topical non-steroidal anti-inflammatory drugs (NSAIDs) (n = 36) as adjunct therapy showed no significant advantage in anatomical outcomes or BCVA gain when compared to those without NSAIDs (all p > 0.05). Triamcinolone acetonide remained significant for proportional and absolute improvement in foveal thickness (p = 0.019 and p = 0.006) and in central subfield macular thickness (p = 0.013 and p = 0.006) when controlled for confounding factors patient age and gender and topical NSAID use.

Conclusions: Intraoperative intravitreal use of triamcinolone acetonide improved short-term anatomical outcomes in patients who underwent epiretinal membrane surgery.

Keywords: ERM peeling; NSAIDs; epiretinal membrane surgery; triamcinolone acetonide.