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Peter M Kally, Tara A McCannel, Colin McCannel; Asymmetric retinal thinning after epiretinal membrane peel. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1064.
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© 2017 Association for Research in Vision and Ophthalmology.
To evaluate macular changes following vitrectomy for epiretinal membrane (ERM) peeling for macular pucker. This retrospective case-control study was designed to examine the operative and long-term effects of ERM peel operations on macular structure.
Institutional Review Board (IRB) approval obtained for patients with idiopathic ERMs who received a pars plana vitrectomy (PPV) and ERM peel between 2010 and 2015. Major inclusion criteria were availability of Heidelberg optical coherence tomography (OCT) images before and after epiretinal membrane peeling and pseudophakia at last follow up. Exclusion criteria were based on presence of any retinal or ocular co-morbidity that would affect visual acuity independent from the ERM. A total of 47 control eyes were selected from the fellow non-operated eyes as long as no ocular morbidity was present, including epiretinal membranes. Data collected on preoperative and follow-up clinic visits included macular subfield thickness, foveal distance from optic nerve, pseudophakic status and concurrent use of indocyanine green (ICG) and inner limiting membrane (ILM) peeling during surgery. Results were examined with two-tailed Student’s t-testing, a p-value <0.05 was used for statistical significance.
A total of 52 cases and 47 controls met all inclusion and exclusion criteria and were studied. The average follow-up was 27 months (range 7-44 months). Mean pre-operative temporal subfield thickness (TST) = 418.9nm (SD ± 61.8), and nasal subfield thickness (NST) = 430.2nm (SD ± 53.0), decreasing on follow-up TST = 339.1nm (SD ± 41.2) and NST = 374.0 (SD ± 35.0). The difference between the change in TST and NST was significant (p = <0.001). There was no significant difference in nasal or temporal subfield changes when the operative eyes were stratified by use of ICG (n=12), or ILM peeling (n=15). Foveal distance from optic nerve did not change significantly on follow-up p=0.602.
Following vitrectomy with ERM peeling there is a greater reduction in the temporal retinal subfield thickness than than nasal retinal subfield. Intraoperative use of ICG and ILM peeling did not appear to affect the amount of thinning measured. There was no change in foveal location relative to optic nerve detected.
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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