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Sushant Wagley, Taiga Kinoshita, Kyle D. Kovacs, Jorge G. Arroyo; Morphological Differences in Epiretinal Membranes on Ocular Coherence Tomography as a Predictive Factor for Surgical Outcome. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4479.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate whether morphological differences in idiopathic epiretinal membranes (ERM) seen on optical coherence tomography (OCT) may help predict surgical outcomes.
Seventy-five eyes of 74 patients who underwent primary pars plana vitrectomy with membrane peeling were retrospectively reviewed. Outcome measures included visual acuity, macular contour on OCT, central macular thickness, and reoperation rate.
According to the preoperative macular contour, 75 eyes were categorized into 4 types; 42 eyes were included in the diffuse (DIF) type, 12 in the cystoid macular edema (CME) type, 14 in the pseudo-lamellar hole (PLH) type, and 7 in the vitreomacular traction (VMT) type. Surgery significantly improved vision in all types except for the PLH type (DIF p<0.0001; CME p=0.0378; PLH p=0.838; and VMT p=0.0273, respectively). There was a significant relationship between preoperative and postoperative macular contour. All preoperative VMT showed normal contour on postoperative OCT but had the highest reoperation rate.
Surgical intervention for the PLH type ERM was not associated with the visual improvement seen in other ERM types, and the VMT type had the highest reoperation rate. Future studies should evaluate the potential benefit of internal limiting membrane peeling with or without short term gas tamponade in these cases.
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