Prevalence and Risk Factors for Epiretinal Membranes in a Multi-Ethnic United States Population

Abstract

Purpose To describe the prevalence of and risk factors for epiretinal membrane (ERM) in a multi-ethnic population and to evaluate possible racial/ethnic differences. Design Cross-sectional study. Participants Participants of the Multi-Ethnic Study of Atherosclerosis (MESA), examined at the second visit of the MESA when retinal photography was performed. Methods Data on 5960 participants aged 45 to 84 years from MESA, including white, blacks, Hispanic and Chinese from six United States communities, were analysed. ERM was assessed from digital non-stereoscopic fundus photographs and defined as cellophane macular reflex (CMR) without retinal folds or pre-retinal macular fibrosis (PMF) with retinal folds. Risk factors were assessed from standardized interviews, clinical examinations, and laboratory investigations. Main outcome measures ERM prevalence by ethnic/racial group, and risk factors associated with ERM. Results The prevalence of any ERM was 28.9%, of which 25.1% were CMR and 3.8% were PMF. The prevalence of ERM was significantly higher in Chinese (39.0%), compared to Hispanics (29.3%), whites (27.5%), and blacks (26.2%), p<0.001. In multivariable models, increasing age (odds ratio [OR] 1.19, 95% confidence intervals [CI], 1.06, 1.34, per year increase in age), diabetes (OR 1.92, 95% CI, 1.39, 2.65) and hypercholesterolemia (OR 1.33, 95% CI, 1.04, 1.69) were significantly associated with CMR. Conclusions This study showed that ERM was significantly more common in Chinese persons compared to whites, blacks and Hispanics. Risk factors for epiretinal membrane were increasing age, presence of diabetes and hypercholesterolemia.