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Raouf Gaber, Qisheng You, Mostafa Alam, Ilkay Kilic, Nadia Mendoza, Frank Tsai, William R Freeman; Characteristics of Epiretinal Membrane Remnant Edge by Optical Coherence Tomography after Pars PlanaVitrectomy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4055.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the incidence, predictors ,characteristics, and progression of epiretinal membrane (ERM) remnant edge seen by optical coherence tomography (OCT) after pars plana vitrectomy (PPV) with ERM removal.
A retrospective chart review was conducted for 85 consecutive patients with 86 eyes diagnosed with ERM who underwent PPV with epiretinal membrane peel between 2013 and 2014. Data collected and analyzed included age, gender, pre- and post-operative visual acuity, use of indocyanine green (ICG) stain for internal limiting membrane (ILM) peeling, type of tamponade used after vitrectomy, ERM edge boundaries, presence of cystoid macular edema, and central foveal thickness.
An ERM remnant edge was detected in 33/86 study eyes (38.4%) at the first post-operative OCT scan, Compared to those without an ERM remnant, patients with an ERM remnant after surgery were significantly older at baseline and had a higher incidence of ERM recurrence at their last visit. They were not significantly different in terms of gender, pre- and post-operative visual acuity, reduction of central foveal thickness from baseline, proportion of eyes with pre-operative ERM elevation on OCT, presence of macular edema before surgery, intra-operative ICG staining with ILM peel, or tamponade used.Based on the edge morphology, we further classified the ERM remnant into three types: type 1 was flat and blended with the retina (14/33 eyes, 42.4%), type 2 was flat but stepped (17/33 eyes, 51.5%), type 3 was elevated (2/33 eyes, 6.0%). A significantly higher risk of ERM recurrence was seen in type 2 and type 3 ERM remnants (75% and 100% of eyes, respectively) than those with a type 1 ERM remnant (10% of type 1 eyes).
An ERM remnant edge was detected by OCT after PPV with ERM removal in 38.4% of eyes. The presence of a post-operative ERM edge was associated with a higher risk of ERM recurrence, particularly in the type 2 and type 3 edges, but not with post-operative visual acuity or central foveal thickness.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Classification of ERM edge remnant Type 1 Flat and blended with the retina Type 2 Flat and stepped Type 3 Elevated edge
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