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Alexander Barnes, Peter K Kaiser; The effect of baseline optical coherence tomography characteristics on surgical outcomes in patients with epiretinal membrane. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2815.
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Though various prognostic variables for post-operative outcomes following epiretinal membrane (ERM) peel have been identified, little is known about how pre-operative optical coherence tomography (OCT)-based categorization of ERM architecture impacts surgical outcomes. We performed a retrospective, observational clinical study to examine the relationship between ERM surgical outcomes and the pre-operative OCT classification of ERMs.
58 eyes of patients who underwent vitrectomy with ERM peel were categorized based on pre-operative OCT characteristics relating to a previously published classification scheme (Konidaris et al.). Best corrected visual acuity (BCVA) and central subfield thickness (CST) were measured pre-operatively and at one, three, and six months after surgery. Pre-operative OCT was classified into the following groups: folding, edema, cystoid macular edema, lamellar macular hole, vitreomacular traction (VMT) with edema, or VMT with schisis.
All groups experienced an average gain in BCVA based on approximate Early Treatment Diabetic Retinopathy Study (ETDRS) scores. Those in the lamellar hole group had the fewest letters gained on average (12) between their pre-operative and six-month assessments, while those in the VMT with edema group had the greatest gains (24 letters). Eyes in the lamellar hole group also had the least change in central subfield thickness (55 microns) when comparing pre-operative and post-operative measurements at six months. The VMT with schisis category had the greatest reduction in CST at six months post-operatively (362 microns). All groups had an average decrease in CST at six months.
Certain epiretinal membrane subtypes may be more likely to experience desirable surgical outcomes (improved BCVA and decreased CST). Pre-operative OCT categorization of ERMs may provide useful prognostic information for clinicians and patients.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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