Epidemiological insights into epiretinal membranes using optical coherence tomography: the Singapore Epidemiology of Eye Diseases Study-2

BACKGROUND: To investigate prevalence and risk factors of epiretinal membrane (ERM), particularly those associated with ERM severity, in a multi-ethnic Asian cohort using optical coherence tomography (OCT). METHODS: A total of 6762 Malays, Indians and Chinese from the Singapore Epidemiology of Eye Diseases (SEED) Study cohort underwent a comprehensive evaluation. OCT macular scans were primarily used to assess the presence of ERM. ERM was classified into three stages based on structural characteristics on OCT images and as either primary or secondary. The data acquired were analysed using various multivariable logistic regression analyses to identify the potential risk factors. RESULTS: The age-standardised prevalence of any ERM was 14.5% in Malays, 13.6% in Indians and 16.3% in Chinese. Older age (OR 1.05 (95% CI 1.04 to 1.06)), female gender (OR 1.34 (95% CI 1.13 to 1.59)), Chinese ethnicity (OR 1.23 (95% CI 1.01 to 1.50) vs Malays; OR 1.71 (95% CI 1.39 to 2.10) vs Indians) and longer axial length (OR 1.19 (95% CI 1.13 to 1.26)) were risk factors for primary ERM. Significant risk factors for primary ERM severity were older age (OR 1.04 (95% CI 1.01 to 1.07)) and cardiovascular disease (CVD) (OR 2.17 (95% CI 1.03 to 4.57)), while for severe secondary cases were Chinese ethnicity (OR 2.07 (95% CI 1.18 to 3.63) vs Malays; OR 2.49 (95% CI 1.42 to 4.38) vs Indians) and higher glycated haemoglobin (HbA1c) level (OR 1.39 (95% CI 1.15 to 1.67)). CONCLUSIONS: ERM was more prevalent among Chinese adults in the SEED cohort. Older age and CVD were risk factors for primary ERM severity, while Chinese ethnicity and higher HbA1c were associated with severe secondary cases.