The Role of Gliosis in Idiopathic Epiretinal Membranes: New Insights

Baseline and 6-months measurements included Snellen acuity (SA), central retinal thickness (CRT), the presence of microcystic macular edema (MME), outer retinal cysts (ORC), disruptions of the ellipsoid zone (EZ) and external limiting membrane (ELM) and quantitative analysis on MC-SLO were analyzed. The study primarily evaluated postoperative SA improvement, CRT reduction, and the prevalence of ERM remnants. Additionally, the relationship between gliotic components and postoperative outcomes was analyzed. In stage 2 ERMs, clear ERMs had a higher incidence of ERM remnants after surgery (81.8% vs. 30.8%, p = 0.037). Both groups experienced visual acuity improvement (clear ERMs: +25 ETDRS letter score, cloudy ERMs: +15 ETDRS letter score p = 0.013). In stage 3 ERMs, no significant differences in SA or CRT changes were noted, but clear ERMs showed more inner retinal dimples (p = 0.015). Gliosis area and EIFL thickness showed significant correlation in cloudy stage 3 ERMs (p = 0.011). Clear and cloudy ERMs differ in postoperative recovery. Cloudy stage 2 ERMs have less functional recovery but fewer remnants than clear ERMs. In stage 3, gliosis correlates with EIFL severity, and clear ERMs exhibit more inner retinal dimples.