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Sun Young Lee, Lisa C Olmos; Retinal anatomical features after vitrectomy for idiopathic epiretinal membrane as seen on spectral-domain optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1165.
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To assess the recovery of retinal anatomical changes after idiopathic epiretinal membrane (ERM) surgery using spectral-domain optical coherence tomography (SD-OCT).
Pre-operative and post-operative Cirrus SD-OCT scans were retrospectively collected from 10 eyes of 10 patients who underwent pars plans vitrectomy and inner limiting membrane (ILM) peeling for treatment of symptomatic idiopathic epiretinal membrane. Detailed anatomical features on SD-OCT pre-operatively were analyzed and compared with those at approximately 1, 3, 5 and 12 months post-operatively.
On pre-operative SD-OCT exam, in addition to ERM, loss of normal foveal contour, increased retinal thickness and microfolds of the inner retina were observed in all eyes. In 6 eyes, intraretinal cysts were also identified. After ERM surgery, loss of the normal foveal contour and increased retinal thickness improved gradually until 12 months, however neither ultimately returned to normal. Microfolds of the inner retina also improved in all cases and furthermore completely resolved in 2 eyes within 3 months. Those resolved microfolds were not associated with preexisting intraretinal cysts. On the other hand, increasing intraretinal cysts were observed in 2 eyes post-operatively where focal remnants of the membrane were identified.
SD-OCT was useful to analyze the recovery of retinal anatomical changes after ERM surgery. The anatomical changes caused by idiopathic ERM tend to improve after ERM surgery; however, the appearance of the macula does not fully normalize during 1 year follow-up, and may not ever fully normalize. Classification and description of the natural course of postoperative appearance of the macula on OCT after ERM surgery may be helpful to clinicians managing these patients.
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