Abstract
Purpose:
To evaluate contrast sensitivity (CS) in patients undergoing vitrectomy for epiretinal membrane (ERM), and to investigate the relationship between CS and foveal microstructures with spectral-domain optical coherence tomography (SD-OCT).
Methods:
Forty-one eyes of 41 patients with idiopathic ERM were included. We examined contrast sensitivity with CSV-1000E, the minimal angle of resolution best-corrected visual acuity (log MAR BCVA) and foveal microstructure with SD-OCT before and 6 months after surgery. From the data obtained with CSV-1000E, the area under the log contrast sensitivity function (AULCSF) was calculated. Based on the obtained OCT images, we divided the 1.0mm x 1.0mm area centered on the fovea into 9 sections and quantified the following parameters using an image-processing program: mean thickness of the ganglion cell layer (GCL), inner nuclear layer (INL), and outer retinal layer (ONL+OPL: outer nuclear layer and outer plexiform layer). The statuses of the photoreceptor inner and outer segment junction (IS/OS) and external limiting membrane (ELM) were also evaluated.
Results:
Vitrectomy significantly improved logMAR BCVA and AULCSF. Even in 17 of 41 patients with poor improvement of visual acuity (changes in logMAR BCVA by surgery was ≤ 0.2), postoperative AULCSF had significantly increased by treatment (p < 0.05). Postoperative AULCSF showed a significant correlation with preoperative and postoperative ONL+OPL thickness (p < 0.005, p < 0.05, respectively), whereas other parameters were not relevant. Postoperative logMAR BCVA significantly correlated with preoperative and postoperative status of IS/OS (p < 0.05, p < 0.05, respectively), and preoperative ONL+OPL thickness (p < 0.005). Postoperative logMAR BCVA was not associated with postoperative ONL+OPL thickness (p = 0.088).
Conclusions:
In ERM patients, contrast sensitivity improved even though their visual acuity did not recover significantly by vitrectomy. Contrast sensitivity was associated with the thickness of outer retinal layer, while visual acuity was associated with the status of IS/OS.
Keywords: 762 vitreoretinal surgery •
478 contrast sensitivity •
688 retina