September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Five-Year Functional Outcomes after Epiretinal Membrane Surgery: A Prospective, Controlled Study
Author Affiliations & Notes
  • Gowtham Jonna
    Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Ian A. Thompson
    Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Stephen J Kim
    Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Footnotes
    Commercial Relationships   Gowtham Jonna, None; Ian Thompson, None; Stephen Kim, None
  • Footnotes
    Support  Unrestricted grant from Research to Prevent Blindness, Inc., New York, New York, to the Vanderbilt University School of Medicine Department of Ophthalmology and Visual Sciences.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1095. doi:
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      Gowtham Jonna, Ian A. Thompson, Stephen J Kim; Five-Year Functional Outcomes after Epiretinal Membrane Surgery: A Prospective, Controlled Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1095.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : Prospective data on the long-term outcomes after vitrectomy surgery with membrane peeling is lacking. As part of the 5-year Prospective, non-randomized, controlled Retinal and Optic nerve Vitrectomy Evaluation (PROVE) study, we sought to evaluate functional outcomes involving the inner retina after epiretinal membrane surgery.

Methods : The study eye (SE) and fellow eye (FE) of 20 patients undergoing epiretinal membrane (ERM) surgery were examined preoperatively and at 3, 12, 24, 36, 48, and 60 months postoperatively. Retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thicknesses were recorded and analyzed using spectral-domain optical coherence tomography. Humphrey Visual Field (HVF) mean deviation (MD), pattern standard deviation (PSD), and qualitative HVF changes were assessed and compared over time between study and fellow eyes.

Results : The overall mean GC-IPL thicknesses were 69.3 +/- 5.09 microns in the study group and 76.6 +/- 4.44 microns in the control group. Mean GC-IPL thickness in SEs was less than that of FEs at all time points with progressive thinning in SEs after ERM surgery. There was a significant difference between mean GC-IPL thickness in SEs and FEs at baseline and at 3 months (p = 0.002) but not at later evaluations. However, there was significant thinning of the superotemporal GC-IPL in SEs as compared to FEs at 0, 3, 36, and 48 months (p < 0.05); approached significance at 12 and 24 months (p < 0.10). When compared to baseline, SEs demonstrated significant thinning of the inferior GC-IPL at all time points up to 4 years (p < 0.05). HVF mean MD was greater in SEs as compared to FEs but statistically significant only at 0, 12, and 24 months (p < 0.05). PSD increased from baseline in SEs but remained near baseline in FEs. There was no statistically significant difference between PSD in SEs versus FEs at all time points.

Conclusions : Surgical eyes demonstrated progressive thinning of the GC-IPL as compared to fellow controls after ERM surgery. This difference was statistically significant or approached significance for the superotemporal quadrant. As compared to baseline, surgical eyes demonstrated significant thinning of the inferior GC-IPL postoperatively. HVF MD and PSD demonstrated worsening trends post-ERM surgery. The results of PROVE highlight inner retinal and functional changes that persist 5 years after ERM surgery.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

 

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