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Saujanya Vadoothker, Olga Shif, Phillip Scharper; Changes in inner nasal macular thickness and retinal sensitivity after idiopathic epiretinal membrane removal. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1094.
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© 2017 Association for Research in Vision and Ophthalmology.
To analyze changes in inner nasal macular thickness and retinal sensitivity in patients undergoing pars plans vitrectomy (PPV) for idiopathic epiretinal membrane removal (ERM) removal. We hypothesize that ERM removal will result in a decrease in retinal thickness with a corresponding increase in retinal sensitivity.
Retrospective chart review analyzing all patients undergoing PPV for ERM removal in past five years. Eyes with diabetic retinopathy, vascular occlusions, and other significant macular or optic nerve pathology were excluded. Fifteen eyes from twelve patients were included. All patients underwent 23G PPV (Constellation, Alcon) with atraumatic ERM and internal limiting membrane (ILM) removal with indocyanine green (ICG). Average macular thickness and sensitivity values in nine sectors were measured by spectral-domain optical coherence tomography (OCT) and microperimetry (Optos). Statistical analysis was performed using a paired t-test.
Mean followup was 30 months. All 9 sectors on macular OCT analysis showed a decrease in retinal thickness postoperatively. The mean preoperative and postoperative combined inner and outer nasal macular thickness values were 346 µm and 322 µm (p <0.05). However, the preoperative to postoperative percentage change in retinal thickness in the inner nasal region was disproportionately less compared to the outer nasal, central, and temporal retinal thickness values (p <0.05). Preoperative mean inner nasal thickness was 376 µm and postoperative mean thickness was 355 µm. Preoperative mean outer nasal thickness was 315 µm compared to postoperative mean thickness of 289 µm. The relative increased thickness of the inner nasal region corresponded with a decrease in retinal sensitivity from 16.1 dB preop to 14.7 dB postop (p = 0.3).
The overall decrease in mean nasal macular thickness can likely be attributed to ERM removal. However, the disproportionate increase in thickness in the inner nasal region with its corresponding decrease in retinal sensitivity is unexpected. This change could be attributed to structural retinal changes caused by the ERM itself, or perhaps related to the ILM removal, which may adversely affect the inner nasal macula. Further studies are necessary to elucidate the cause.
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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