Abstract
Purpose: :
To evaluate early postoperative changes after vitrectomy with two different staining protocols for idiopathic epiretinal membranes (ERMs) using high-definition optical coherence tomography (Cirrus HD-OCT). Correlations with standard-resolution OCT (Stratus OCT 3000) and visual acuity (VA) as well as differences between the staining groups were assessed.
Methods: :
Patients presenting with idiopathic ERMs were preoperatively randomized into group 1 with trypan blue (TB) -assisted plana vitrectomy or into group 2 with indocyanin green (ICG)-assisted pars plana vitrectomy. Main outcome measures included HD-OCT and standard-resolution OCT imaging and best corrected distance and near visual acuity (DVA, NVA).
Results: :
Up to now, 16 patients have been included. Fourteen patients (88%) showed an improved or stable final DVA, whereas 12 patients (75%) showed an improved or stable final NVA. No significant difference between the two dyes was found for the main outcome measures (p>0.05). While a decrease of the mean retinal thickness was seen in both types of OCT (HD-OCT: 448 µm to 378µm versus standard-resolution OCT: 410µm to 326 µm), assessment of the extent of the ERM and the distortion and dynamic interactions of the vitreoretinal interface was only possible in the HD-OCT images. The baseline VA correlated significantly with the mean baseline retinal thickness from both types of OCT. A correlation at the one week and one month postoperative assessment was found, but showed no statistical significance. Furthermore the decrease of the vertical irregularities of the vitreoretinal interface was reflected in an increase of DVA and NVA and vice versa.
Conclusions: :
The HD-OCT allows a more precise diagnosis and monitoring of ERMs than the standard-resolution OCT. Due to the preliminary nature of our data we can not conclude that changes of the vitreofoveal interface visualized with the HD-OCT can be used to predict the visual outcome after surgery.
Clinical Trial: :
www.clinicaltrials.gov NCT00437593
Keywords: macula/fovea • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • vitreoretinal surgery