Preretinal Hyperreflective Dots: A novel OCT Sign Associated With The Development Of Epiretinal Membrane After Vitrectomy For Rhegmatogenous Retinal Detachment

Purpose: To investigate the association between preretinal hyperreflective dots (PHD) with the occurrence of epiretinal membrane (ERM) following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). Methods: This retrospective study included patients who underwent PPV for RRD at Ophtalmopôle de Paris. Optical coherence tomography (OCT) scans were acquired at 1, 3, 6 months and 1 year post-surgery. PHD were defined as point-like hyperreflective deposits on the inner retinal surface on the first postoperative OCT. The association between PHD and ERM was evaluated using logistic regression and Kaplan-Meier analysis. Results: Of 894 patients who underwent vitrectomy for RRD, 417 were included in the analysis. Univariate analysis showed significant associations between ERM occurrence and macula-off RRD ( P =0.043), number of retinal tears ( P =0.002), use of cryopexy ( P =0.012), C2F6 tamponade ( P =0.045), and presence of PHD on OCT ( P <0.001). On multivariate analysis, presence of PHD ( P <0.001) and use of cryopexy ( P =0.013) were significant predictors of ERM. Kaplan-Meier analysis indicated that the cumulative probability of developing an ERM at 6 months was 4% in patients without PHD and 26% in patients with PHD (P<0.001). Conclusion: PHD are associated with the occurrence of ERM following vitrectomy for RRD.