Abstract
Purpose :
Many retinal and choroidal diseases have been shown to have fluctuations in choroidal thickness. Furthermore, several authors have cited changes in choroidal thickness following retinal surgery. This study aims to evaluate subfoveal choroidal thickness (SFCT) and central macular thickness (CMT) before and after pars plana vitrectomy (PPV) with indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling for epiretinal membrane (ERM) and full-thickness macular hole (FTMH).
Methods :
A retrospective, consecutive, fellow-eye controlled, interventional series of subjects undergoing PPV with ICG-assisted ILM peeling for ERM and FTMH was conducted. SFCT was measured via enhanced depth imaging OCT (EDI-OCT) and CMT was obtained from the center subfield of the macular thickness map before and after vitrectomy in study and fellow eyes using spectral domain OCT.
Results :
A total of 121 eyes of 121 subjects (62 ERM, 59 FTMH) were included. The mean age of patients was 68.2 ± 11.6 years in the ERM group and 61.9 ± 14.2 years in the MH group. Aside from this, the only additional significant difference between the MH and ERM groups was mean CMT at baseline and follow up in both study and fellow eyes.
No significant changes in choroidal thickness were observed when comparing pre- and post-operative values in ERM and MH groups (p=0.80 and p=0.98). The ERM group had baseline SFCTs of 183 ±88.2 μm at baseline and 181±87.0 μm at followup; the MH group had baseline SFCTs of 178 ±66.6 μm at baseline and 178±66.9 μm at followup. CMT was significantly decreased in both groups (p<0.0001, p<0.0001).
SFCT had a negative correlation with age in diseased eyes both at baseline (p<0.001) and postoperatively (p<0.001) compared to fellow eyes (p=0.055). Subgroup analysis of SFCT controlled for CMT was not statistically significant.
Conclusions :
Microincision PPV with adjunctive ICG for ERM and FTMH does not significantly alter SFCT in the treatment of ERM and MH, even though ICG directly contacts the retinal pigment epithelium in the case of MH. Further prospective studies are required to elucidate whether choroidal thickness plays an integral role in the pathophysiology of certain entities or whether changes in choroidal thickness merely represent vascular congestion which is a marker for other mechanisms of disease.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.