Abstract
Purpose :
Retinal microstructure in the macula has been reported to be associated with the visual outcome of epiretinal membrane (ERM) after vitrectomy. Given that glaucoma causes significant thinning of the inner retinal layers in the macula, comorbidity of glaucoma may modify the functional and structural abnormalities caused by ERM. We investigated the influence of retinal microstructure and glaucoma on postoperative visual outcome of ERM.
Methods :
Consecutive ERM cases which underwent vitrectomy with internal limiting membrane peeling (25 eyes of 25 patients with glaucoma, G group; 54 eyes of 54 patients without glaucoma, C group) were studied. Best-corrected visual acuity (BCVA), metamorphopsia evaluated with M-charts (M-score), and microstructural abnormalities (defects in outer limiting membrane/ ellipsoid zone/ cone outer segment tip, microcystic macular edema, and retinoschisis) and retinal layer thickness (central foveal thickness and parafoveal thickness of total retina/ inner nuclear layer/ outer plexiform layer plus outer nuclear layer) evaluated with optical coherence tomography (RS-3000, NIDEK) were examined preoperatively and 6 months postoperatively, and were compared between G and C groups. Associated factors with postoperative BCVA and M-score in all cases (G+C groups) were determined by multiple regression analysis.
Results :
BCVA improved from 0.25±0.20/ 0.17±0.21 to 0.07±0.13/ 0.005±0.12 (G/C groups; p<0.001, p<0.001), and postoperative BCVA in C group was better than G group (p=0.02). M-score decreased from 0.54±0.43/ 0.71±0.60 to 0.27±0.29/ 0.43±0.51 (G/C groups; p<0.001, p=0.001), and there were no differences between groups. Postoperative ellipsoid zone defect was more frequent in G group (4/25 vs.1/54, p=0.03). Postoperative BCVA was significantly associated with preoperative BCVA and postoperative ellipsoid zone defect, while postoperative M-score was significantly associated with preoperative M-score and inner nuclear layer thickness, and with postoperative microcystic macular edema and thickness of outer plexiform layer plus outer nuclear layer. Comorbidity of glaucoma was not associated with either outcome.
Conclusions :
Retinal microstructure, but not glaucoma, had significant influence on postoperative visual acuity and metamorphopsia of ERM.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.