Intraoperative Retinal Changes May Predict Surgical Outcomes After Epiretinal Membrane Peeling.

Journal Article (Journal Article)

Purpose

To investigate whether intraoperative retinal changes during epiretinal membrane (ERM) peeling affect anatomic or functional outcomes after surgery.

Methods

We measured retinal thickness using an intraoperative optical coherence tomography (iOCT) device in patients undergoing pars plana vitrectomy with membrane peeling for idiopathic ERM. Changes in intraoperative central macular thickness (iCMT) were compared with postoperative improvements in CMT and best-corrected visual acuity (VA).

Results

Twenty-seven eyes from 27 patients (mean age 68 years) underwent iOCT-assisted ERM peeling surgery. Before surgery, mean VA was logMAR 0.50 ± 0.36 (Snellen 20/63), and mean baseline CMT was 489 ± 82 µm. Mean iCMT before peeling was 477 ± 87 µm, which correlated well with preoperative CMT (P < 0.001). Mean change in iCMT was -39.6 ± 37 µm (range -116 to +77 µm). After surgery, VA improved to logMAR 0.40 ± 0.38 (Snellen 20/50) at month 1 and logMAR 0.27 ± 0.23 (Snellen 20/37) at month 3, whereas CMT decreased to 397 ± 44 µm and 396 ± 51 µm at months 1 and 3. Eyes that underwent greater amount of iCMT change (absolute value of iCMT change) were associated with greater CMT reduction at month 1 (P < 0.001) and month 3 (P = 0.010), whereas those with greater intraoperative thinning (actual iCMT change) showed a trend toward better VA outcomes at months 1 (P = 0.054) and 3 (P = 0.036).

Conclusions

Intraoperative changes in retinal thickness may predict anatomic and visual outcomes after idiopathic ERM peeling surgery.

Translational relevance

Our study suggests that intraoperative retinal tissue response to ERM peeling surgery measured by iOCT may be a prognostic indicator for restoration of retinal architecture and for visual acuity outcomes.

Full Text

Duke Authors

Cited Authors

  • Mukkamala, LK; Avaylon, J; Welch, RJ; Yazdanyar, A; Emami-Naeini, P; Wong, S; Storkersen, J; Loo, J; Cunefare, D; Farsiu, S; Moshiri, A; Park, SS; Yiu, G

Published Date

  • February 2021

Published In

Volume / Issue

  • 10 / 2

Start / End Page

  • 36 -

PubMed ID

  • 34003921

Pubmed Central ID

  • PMC7910632

Electronic International Standard Serial Number (EISSN)

  • 2164-2591

International Standard Serial Number (ISSN)

  • 2164-2591

Digital Object Identifier (DOI)

  • 10.1167/tvst.10.2.36

Language

  • eng