June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Temporal pattern of macular thickness resolution and visual acuity improvement after epiretinal membrane peel surgeries
Author Affiliations & Notes
  • Ashley Campbell
    Ophthalmology, Massachusetts Eye and Ear, Boston, MA
  • Demetrios Vavvas
    Ophthalmology, Massachusetts Eye and Ear, Boston, MA
  • Footnotes
    Commercial Relationships Ashley Campbell, None; Demetrios Vavvas, MEEI (P), Kala pharmaceuticals (C), Roche (C), Genentech (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5810. doi:https://doi.org/
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      Ashley Campbell, Demetrios Vavvas; Temporal pattern of macular thickness resolution and visual acuity improvement after epiretinal membrane peel surgeries. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5810. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: The aim of this study was to determine the temporal pattern of central macular thickness (CMT) improvement after epiretinal membrane peel surgeries performed at a teaching institution (Massachusetts Eye and Ear Infirmary).

Methods: This is a retrospective review of 23 patients who underwent vitrectomy and membrane peel for idiopathic epiretinal membrane (ERM) between 2010-2012 at the Massachusetts Eye and Ear Infirmary. Visual acuity and spectral-domain optical coherence tomography (SD-OCT) images were analyzed to compare pre-operative values from post-operative day one (POD1), and week one (POW1), and months 1-3 (POM1-3).

Results: Of the 23 patients reviewed, 16 had pars plana vitrectomy (PPV) with membrane peel (MP) alone and 7 had PPV/MP with phacoemulsification of their cataract at the same time. Pre-operatively, the average visual acuity (VA) was 0.65 log minimal angle of resolution (logMAR) (standard deviation ± 0.30) and the average OCT central macular thickness (CMT) was 476 μm ± 90. The average visual acuity at POD1, POW1, and POM1-3 was 1.00 logMAR ± 0.45, 0.77 logMAR ± 0.53, and 0.49 logMAR ± 0.29, respectively, demonstrating that while visual acuity initially worsened in the immediate post-operative period, it eventually improved during the POM1-3 time frame. Ultimately, 73.9% of patients enjoyed an improvement in visual acuity, with an average improvement of -0.17 logMAR (P=0.02). The average CMT at POD 1, POW1, and POM1-3 was 428 μm ± 98, 399 μm ± 106, and 349 μm ± 83, respectively. This represents a 25.1% (P=0.004), 35.2% (P=0.002), and 53.9% (P<0.001) reduction in CMT at POD1, POW1, and POM1-3, respectively, as compared to pre-operative values. The top five responders at POW1, who had an average 70% reduction in CMT, ultimately had an average improvement in VA of -0.48 logMAR, which is markedly better than the overall average. Conversely, the bottom five responders at POW1 had an average 5% increase in CMT, which were associated with an overall average -0.17 logMAR reduction in VA.

Conclusions: Our study shows that 50% of the anatomical improvement after ERM peel surgery is seen in the first day/week after the surgery. Improvement of macular thickness precedes the VA improvement and the improvement seen in the first week can be used to help predict the final visual acuity.

Keywords: 762 vitreoretinal surgery • 585 macula/fovea • 550 imaging/image analysis: clinical  

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