Ophthalmol Sci. 2026 May 12;6(7):101228. doi: 10.1016/j.xops.2026.101228. eCollection 2026 Jul.
ABSTRACT
PURPOSE: To investigate the impact of epiretinal membrane (ERM) on the structural characteristics of acquired vitelliform lesions (AVLs) in eyes with intermediate age-related macular degeneration (iAMD).
DESIGN: Cross-sectional study.
PARTICIPANTS: Eyes of patients with iAMD-associated AVLs were identified from a tertiary referral center database.
METHODS: Multimodal imaging, including spectral-domain OCT, was reviewed. Eyes were stratified according to the presence (ERM + AVL) or absence (AVL-only) of ERM. Quantitative OCT parameters, including apical AVL height and width, and qualitative structural features such as intraretinal hyperreflective foci (IHRF), ellipsoid zone (EZ), and external limiting membrane (ELM) disruption, and AVL location relative to drusen, were assessed by masked graders. Effect sizes were calculated using Hedges’ g. Group comparisons were performed using appropriate parametric or nonparametric tests.
MAIN OUTCOME MEASURES: Differences in AVL structural characteristics between eyes with and without ERM.
RESULTS: A total of 234 eyes with age-related macular degeneration (AMD)-associated AVLs were included, of which 17 eyes had concomitant ERM. Eyes with ERM demonstrated significantly greater apical AVL height compared with AVL-only eyes (169.9 ± 52.5 μm vs. 134.8 ± 55.0 μm; P = 0.016). Acquired vitelliform lesion width was greater in the ERM + AVL group, although this difference did not reach statistical significance (811.1 ± 251.0 μm vs. 676.8 ± 416.0 μm; P = 0.057). The prevalence of IHRF, EZ disruption, ELM disruption, and AVL location over drusen did not differ significantly between groups. Effect size analysis demonstrated a moderate positive effect for apical AVL height (Hedges’ g ≈ 0.65; 95% confidence interval [CI] ∼0.15 to 1.10), whereas AVL width showed a small-to-moderate effect size with CIs crossing 0.
CONCLUSIONS: In eyes with AMD-associated AVLs, the presence of ERM is associated with increased AVL height without corresponding differences in other outer retinal structural features. These findings suggest that vitreomacular traction may selectively influence AVL configuration. Longitudinal studies are needed to determine whether traction-related modulation of AVL morphology impacts AMD disease progression and AVL collapse.
FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
PMID:42383220 | PMC:PMC13315181 | DOI:10.1016/j.xops.2026.101228
