SIGNIFICANCE: Epidemiological information about the epiretinal membrane is important for better clinical management and understanding of the nature and burden of this disease. There are some gaps in our understanding of the epidemiology of epiretinal membranes, particularly in Africa and the Middle East. PURPOSE: This study aimed to determine the prevalence and risk factors of epiretinal membrane using spectral-domain optical coherence tomography (OCT) in an Iranian elderly population. METHODS: This report is a part of a population-based study conducted on the elderly population 60 years and older from Tehran, the capital of Iran, using multistage stratified random cluster sampling. Study participants underwent measurement of visual acuity, autorefraction, subjective refraction, and slit-lamp biomicroscopy. The epiretinal membranes were diagnosed by a retinal specialist from OCT images (Spectralis OCT). RESULTS: A total of 1298 individuals were analyzed for this report. Of these, 58.9% were female, and the mean age of the participants was 67.4 ± 6.4 years. The prevalence rates of all epiretinal membranes, primary epiretinal membrane, and secondary epiretinal membrane were 6.0% (95% confidence interval [CI], 4.6 to 7.5%), 4.7% (95% CI, 3.0 to 6.3%), and 10.1% (95% CI, 6.6 to 13.6%), respectively. According to the multiple logistic regression model, the interaction between age and diabetes (odds ratio [OR], 1.09
95% CI, 1.01 to 1.18, p=0.048) and the presence of posterior vitreous detachment (OR, 2.89
95% CI, 1.45 to 5.78, p=0.003) were significantly linked to a higher prevalence of primary epiretinal membrane. Additionally, a significant inverse relationship was found between the prevalence of primary epiretinal membrane and the number of years of education (OR, 0.91
95% CI, 0.85 to 0.97
p=0.002). CONCLUSIONS: The prevalence of primary epiretinal membrane in Tehran, Iran, was found to be lower than that reported in the majority of earlier studies. Posterior vitreous detachment, interaction between age and diabetes, and lower education level were risk factors of primary epiretinal membrane in this study.