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Joshua Noren Carlson, Rohan J Shah, Stephen Kim; One-year anatomical and functional outcomes after epiretinal membrane surgery: a prospective controlled study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1155.
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To determine 1-year anatomical and functional outcomes of eyes undergoing pars plana vitrectomy and epiretinal membrane (ERM) peeling.
Thirty-six eyes of 18 patients undergoing unilateral ERM surgery were analyzed. Both the surgical eye (SE) and fellow eye (FE) were examined preoperatively and at 3 and 12 months postoperatively. Best corrected visual acuity (BCVA), Humphrey visual field (HVF) data, and spectral domain optical coherence tomography (SD-OCT) of the macula (measurements reported in μm) were recorded at each visit. SD-OCT images were analyzed for changes in the retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL) thickness, outer nuclear layer thickness (ONLT), photoreceptor outer segment length (PROS), and outer foveal thickness (OFT). Statistical analysis was performed using the paired student t-test and Spearman's correlation coefficient.
Although not statistically significant, logMAR BCVA improved in SE from baseline (0.249 ± 0.24) to 12 months (0.195 ± 0.25; p=0.49) but remained lower compared to FE (0.056 ± 0.06; p=0.04). Mean deviation (MD) on HVF was improved in SE (baseline -3.89 ± 0.22) at 3 months (-1.56 ± 2.10; p=0.003) and 12 months (-2.14 ± 1.78; p=0.02) but was lower than FE at 12 months (p=0.04). Temporal RNFL was thicker at baseline in SE (86.7 ± 22.3) compared to FE (71.0 ± 14.4; p=0.008), but no significant differences were observed at 3 or 12 months. In contrast, inferior RNFL thickness was lower in SE (121.6 ± 16.6) compared to FE (125.6 ± 15.2) at 12 months (p=0.02). GCIPL thickness was lower in SE compared to FE at baseline (57.0 ± 25.7 vs. 78.7 ± 6.82, respectively; p=0.002) but not at 12 months (71.2 ± 12.6 vs. 77.5 ± 13.2, p=0.17). ONLT was greater in SE compared to FE at baseline (195.6 ± 81.4 vs. 109.5 ± 18.3, respectively; p<0.001) and 12 months (155 ± 39.8 vs. 117.1 ± 34.6, respectively; p=0.02) but trended towards improvement with time (p=0.07). Small differences were seen at 12 months between SE and FE in PROS (51.9 ± 3.69 vs. 57.9 ± 9.76, respectively; p=0.02) and OFT (83.9 ± 7.38 vs. 89.2 ± 7.60, respectively; p=0.03).
ERM peeling resulted in improvement of MD and GCIPL thinning but not to the level of FE. Temporal RNFL thickening resolved in SE after surgery but inferior RNFL thinning was observed at 12 months. ONLT trended towards improvement following ERM peel.
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