Purchase this article with an account.
Kevin Tan, Jay Chhablani, Renato Lisboa, William R. Freeman; Disruption Of The Photoreceptor Inner Segment/outer Segment Junction And External Limiting Membrane On Spectral-domain Optical Coherence Tomography Are Predictors Of Visual Outcomes After Primary Epiretinal Membrane Surgery. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2609.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study was to evaluate the predictive value of spectral domain-optical coherence tomography (SD-OCT)-determined integrity of the photoreceptor inner segment/outer segment (IS/OS) junction and the external limiting membrane (ELM) on visual acuity in patients undergoing surgery for removal of epiretinal membranes (ERMs).
This is a retrospective, consecutive surgical case series of 32 eyes from 31 patients with primary ERMs who underwent spectral domain-optical coherence tomography scans prior to and following ERM surgery. Multivariate regression analysis was used to calculate the relative contribution of several variables, including extent of photoreceptor IS/OS disruption, extent of external limiting membrane (ELM) disruption, and central macular thickness (CMT) to postoperative best corrected visual acuity (BCVA) and change in BCVA.
The strongest individual predictors of postoperative BCVA among patients who underwent ERM surgery were pre-operative percentage damage of the ELM (r2 = 0.22, P = 0.0075) and pre-operative percentage damage of the IS/OS junction (r2 = 0.24, P = 0.0045) measured on SD-OCT. Interestingly, improvement in visual acuity was correlated with a decrease in CMT (r2 = 0.23, P = 0.021). The most efficient model predicting postoperative BCVA was one which included pre-operative percentage damage of the IS/OS junction, pre-operative percentage damage of the ELM, and the change in CMT (r2 = 0.41, P = 0.001). Additional measured variables did not significantly contribute to visual acuity prediction.
We demonstrate for the first time that disruption of the photoreceptor IS/OS junction and ELM measured on SD-OCT are statistically significant predictors of poor visual acuity outcomes among patients with ERM who undergo surgery, but is most useful when in combination with postoperative CMT. Quantitative improvement in BCVA after ERM surgery is correlated with a decrease in CMT.
This PDF is available to Subscribers Only