Abstract
Purpose: :
To evaluate whether morphologic in ERM seen on OCT may help predict surgical outcomes and Effect of Bevacizumab combination with ERM peeling on each ERM type.
Methods: :
81 eyes of 79 patients with ERM who underwent vitrectomy for ERM peeling were retrospectively reviewed. We classified ERM into idiopathic & secondary according to etiology, and according to preoperative macular contour on OCT, categorized into 4-types(Diffuse, Cystoid macular edema, Pseudolamellar hole, Vitreomacular traction type). Moreover, IS/OS junction status was investigated on OCT. Additionally, we compared surgical outcomes between group of only ERM peeling and group of combination bevacizumab. Main outcome measurements were central macular thickness (CMT) and best-corrected visual acuity (BCVA).
Results: :
In the Idiopathic ERM group, Mean BCVA change was best in the VMT type, followed DIF, PLH, and CME type while in the secondary ERM group, the order was VMT, DIF, CME and PLH type. Mean CMT change was best in VMT type, followed CME, DIF, and PLH type irrespectively etiology. Eye with disruption of IS/OS junction disruption had lower postoperative BCVA and there was better correlation in the idiopathic ERM group than secondary ERM between status of IS/OS junction and VA improvement. In the idiopathic ERM group, Postoperative BCVA was better in subgroup of combination of bevacizumab than subgroup of only ERM peeling. Especially, combination of bevacizumab had significantly better effect in the DIF type ERM than any other type.
Conclusions: :
Morphologic classification in ERM seen on OCT and IS/OS junction status may be a predictive factor for surgical outcomes irrespectively etiology. In addition, concomitant administration of bevacizumab after ERM peeing may help to improve surgical outcomes in the idiopathic ERM, especially diffuse type.
Keywords: retina • vitreoretinal surgery • vascular endothelial growth factor