Stage-specific dynamics of macular pigment optical density as a prognostic biomarker in epiretinal membrane surgery

Purpose To explore macular pigment optical density (MPOD) dynamics in stage 2 and stage 3 epiretinal membranes (ERMs) and to evaluate its pre and postoperative modifications. Furthermore, the study assessed the potential of MPOD as a prognostic biomarker in ERM management. Methods A cohort of stage 2 (n=21) and 3 (n=20) ERM patients, matched for age and gender, underwent clinical evaluation at baseline and postoperative follow-up. Correlations between MPOD and optical coherence tomography parameters were analysed within each group. Results Postoperative MPOD levels significantly differed between stage 2 and 3 ERM patients (p=0.027). Changes in MPOD over time (ΔMPOD) were significantly greater in stage 3 compared with stage 2 participants (p=0.018). In stage 2, ΔMPOD correlated with changes in best-corrected visual acuity (ΔBCVA) (r=0.398, p=0.074) and demonstrated a strong correlation with changes in outer nuclear layer thickness (r=0.672, p<0.001). In stage 3, ΔMPOD exhibited a significant negative correlation with changes in central foveal thickness (r=−0.547, p=0.013) and a positive correlation with ΔBCVA (r=0.510, p=0.022). Conclusions MPOD exhibited stage-specific dynamics and significant postoperative changes. Correlation between ΔMPOD and ΔBCVA in both stages highlights its potential role as a prognostic functional biomarker.