Efficacy of retinal check-up using fundus photography in patients with epiretinal membrane

Purpose: To investigate whether retinal check-ups using fundus photography accurately predicted the visual outcomes of patients undergoing epiretinal membrane (ERM) removal. Methods: We reviewed the medical records of patients who underwent ERM removal by a single surgeon from January 2013 to June 2019. Patients were classified into two groups. The check-up group included patients who underwent fundus photography during their retinal check-ups, and were thus diagnosed with ERMs, even though they lacked any vision-related symptom. The work-up group included patients who underwent fundus photography to rule out retinal abnormalities, because they complained of vision-related symptoms such as decreased vision and metamorphopsia. The best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) findings were compared between the two groups before and 6 months after surgery. Results: The check-up group included 41 eyes and the work-up group 35 eyes. The preoperative BCVA did not differ significantly between the two groups (p = 0.710). However, the proportion of photoreceptor inner segment/outer segment (IS/OS) defects evident on OCT was significantly lower in the check-up than the work-up group (34.1% vs. 68.6%, p = 0.005). Six months after surgery, the BCVA was significantly better in the check-up group (0.07 ± 0.14 logMAR) than in the work-up group (0.19 ± 0.19 logMAR, p = 0.004) and the proportion of patients with poor visual acuity was also significantly lower in the check-up group (2.4%) than the work-up group (22.9%, p = 0.010). Conclusions: We found that a retinal check-up facilitates early detection of an ERM and improves the postoperative visual prognosis. This supports the necessity of fundus photography during retinal check-ups.