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L. M. Pierro, E. Mantovani, S. M. Giatsidis, E. Zampedri, M. Gagliardi, F. Bandello; Preoperative Spectral Domain Optical Coherence Tomography (SDOCT) Evaluation of Vitreopapillary Adhesion (VPA) and Vitreomacular Adhesion (VMA) in the Idiopathic Epiretinal Membrane (IME). Invest. Ophthalmol. Vis. Sci. 2010;51(13):2306.
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to determine the association between vitreopapillary adhesion (VPA), vitreomacular adhesion (VMA) and idiopathic epiretinal membrane (IEM) using Spectral Domain Optical Coherence Tomography (SDOCT), before vitreoretinal surgery.
80 eyes of 80 consecutive patients with IEM were studied using SDOCT. Linear scans were performed on the foveal and optic disc areas. Central foveal thickness (CFT) and retinal nerve fiber layer (RNFL) thickness were analyzed. Epiretinal membranes were graded by an expert OCT interpreter as "adherent": 1, "strongly adherent": 2, or "tractional": 3. The presence of VMA and VPA and foveal depression profile (FDP) were graded as "present": 1, or "absent": 0, while photoreceptor status was graded as "normal": 1, or "altered": 0. The Chi-Square test (95% confidence interval) was used to calculate epiretinal membrane type and VPA, VMA, photoreceptor status, FDP and sex. The Kruskall-Wallis test (95% confidence interval) was used to calculate epiretinal membrane type and CFT, RNFL and age.
At Chi-Square test, the association between VPA and type of epiretinal membrane resulted statistically significant (Chi-Square= 14.5; p=0.0001). VPA was present in 50% of strongly adherent and in 46.2% of tractional epiretinal membrane respectively, while in only 10.7% of the adherent epiretinal membrane. Association between VMA and epiretinal membrane type was also considered statistically significant (Chi-Square = 11,53; p=0.003). VMA was present in 7.1% of strongly adherent epiretinal membrane, in 38.5% of the tractional and in 5.7% of the adherent group respectively. The association between FDP and type of IEM was statistically significant (Chi-Square= 10.08; p=0.006): FDP was not present in 92.3% of the tractional group. There was no statistical significance between types of IEM, sex (p=0.99) and photoreceptor status (p= 0.63). At Kruskall-Wallis test, tractional epiretinal membranes presented higher CFT (p<0.001), while there was no statistical significance between types of epiretinal membrane, RNFL (p=0.75) and age (p=0.58).
VPA and VMA vary depending on the type of epiretinal membrane present. This could be an important factor in the preoperative evaluation of patients.
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