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Tracy M. Wright, Joshua A. Young, John J. Khadem; The Effects Of Epiretinal Membrane Peeling Procedure On Transverse Macular Expansion And Mechanical Aniseikonia. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2606.
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To compare the size of the post-peel retina to pre-peel retina in patients who have had vitrectomy with membrane peeling for epiretinal membranes (ERMs).
A retrospective analysis was performed of color fundus photos of 38 patients who had OCT evaluation before and after an ERM peeling procedure from 2008-2011. All 76 size-matched color fundus photos were obtained from the same Topcon 3D OCT 1000 machine. Image J software (NIH) was used to measure vertical and horizontal macular lengths against identical anatomical landmarks in pre and post-peel eyes. Vertical lengths were measured from a single point on the superior arcade to a point on the inferior arcade, while horizontal lengths were measured from the temporal optic disc edge to a vessel landmark temporal to the fovea. Digital measurements in pixels were taken along vertical and horizontal meridia through the fovea. Comparisons of pre and post-peel lengths were statistically analyzed.
Mean age in our study was 54 ± 12.3 years. Vertical and horizontal transverse macular lengths were both significantly increased after ERM peeling procedure (p<0.001 and p=0.0012, respectively). Of the 38 eyes in our study, 31 (82%) had an increase in vertical transverse length, and 27 (71%) had an increase in horizontal transverse length. The average increase in vertical transverse length was 2.1% while the average increase in horizontal transverse length was 1.4%.
Post-ERM peel eyes had statistically significant macular expansions of 2.1% vertically and 1.4% horizontally compared with pre-procedure eyes. This expansion leads to retinal receptor re-distribution, changes perceived image size, and may induce mechanical aniseikonia of retinal-origin even in the absence of anisometropia.
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