title: Prevalence and risk factors for epiretinal membrane: the Singapore Epidemiology of Eye Disease study.
abstract: To examine prevalence and risk factors of epiretinal membrane (ERM) in a large, contemporary, multiethnic Asian population.
  
  
  
  Combined analysis of three population-based studies of eye diseases, with a total of 9799 Chinese, Malays and Indians residing in the general communities of Singapore. A comprehensive ophthalmic examination, interviews and laboratory blood tests were performed to assess potential risk factors. Digital retinal photographs were used to assess ERM according to a standardised protocol. ERM was classified into cellophane macular reflex (CMR) and/or preretinal macular fibrosis (PMF), and also as primary or secondary (in eyes with other retinal pathology or a history of cataract surgery).
  
  
  
  The age-standardised and ethnicity-standardised prevalence was 12.1% for any ERM, 6.8% for CMR, 6.7% for PMF and 2.8% for bilateral ERM. ERM prevalence was higher in Chinese (13.0%) compared with Malays (7.9%) or Indians (8.7%). In multivariate analysis, significant factors associated with primary ERM were older age (OR 1.08 per year increase; p<0.01), Chinese ethnicity (OR 1.60 vs Indians; p<0.01; OR 1.39 vs Malays; p<0.01), smoking (OR 0.70; p=0.01), longer axial length (OR 1.07 per mm increase; p=0.03) and cataract (OR 0.64; p<0.01). Significant factors independently associated with secondary ERM were older age (OR 1.05; p<0.01), cataract surgery (OR 10.6; p<0.01) and diabetic retinopathy (OR 2.48; p<0.01).
  
  
  
  ERM is common in Asians, particularly among Chinese. Older age is the most consistent risk factor for any ERM, and previous cataract surgery and diabetic retinopathy are the strongest risk factors for secondary ERM.
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.|Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore.
authors.forename: Ning
authors.initials: N
authors.lastname: Cheung
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
authors.forename: Shu-Pei
authors.initials: SP
authors.lastname: Tan
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
authors.forename: Shu Yen
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
authors.forename: Gemmy Chui Ming
authors.initials: GCM
authors.lastname: Cheung
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
authors.forename: Gavin
authors.initials: G
authors.lastname: Tan
authors.affiliation: Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore, Singapore.
authors.forename: Neelam
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.|Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Cheng
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.|Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore.
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data; D019773:Epiretinal Membrane / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology
keywords: Epidemiology; Macula