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Lorenzo Iuliano, Luisa M. Pierro, Marco Gagliardi, Francesco Bandello; Optical Coherence Tomography Anatomical and Functional Evaluation of Ganglion Cell Complex after Surgical Removal of Idiopatic Epiretinal Membranes. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2680.
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© ARVO (1962-2015); The Authors (2016-present)
Neuronal axons histopatological presence in the context of idiopathic epiretinal membranes has been recently reported in literature. Significant reduction of ganglion cell complex (GCC) thickness after surgery for macular hole has been described, too. Implication of these cells in epiretinal membrane formation remains unknown, either from pathogenetic and functional point of view. Aim of this study is to investigate using Spectral Domain Optical Coherence Tomography (SD-OCT) GCC thickness change and functional correlations after vitreoretinal surgery for idiopathic epiretinal membrane.
23 eyes of 22 patients affected by idiopathic epiretinal membrane were prospectively analyzed. Standard vitrectomy and Brilliant Blue®-assisted internal limiting membrane peeling were successfully performed. Macula map (EMM5) and GCC thickness were analyzed using SD-OCT (RTVue-100, Optovue Inc.®, Freemont, CA) 1 day before surgery, 7 days and 6 months after surgery. Best-corrected visual acuity (BCVA) was registered on every visit. 23 healthy subjects coupled for age and sex were included in this study as control.
Preoperative GCC thickness was higher in patients affected by idiopathic epiretinal membrane, compared with healthy eyes (p<0.01). On the 6-month post-surgical control, mean BCVA raised by 14,52 letters (p<0.01), mean foveal thickness was decreased by 82 µm (p<0.01) and mean GCC (mGCC) thickness was reduced by 36.33 µm (p<0.01). mGCC ratio of the total macular thickness (mGCC/macular map) was significantly reduced after surgery by 0.038 (p<0.01). Post-operative BCVA showed significant correlation respectively with mGCC (p<0.01), with mean foveal thickness (p<0.01) and with mGCC/macular map (p=0.02).
GCC thickness decreased 6 months after surgical epiretinal membrane removal and this reduction was proportionally higher than the whole retina thickness reduction. BCVA was significantly raised after surgery, and was inversely correlated with post-operative mean GCC thickness.Our study emphasizes the crucial role of GCC for visual recovery after surgical removal of idiopathic epiretinal membranes.
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