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Alessandra Acquistapace, Matteo Giuseppe Cereda, Mario V Cigada, Ferdinando Bottoni, Giovanni Staurenghi; The different type of contraction of epiretinal membrane in lamellar macular hole. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4061.
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© ARVO (1962-2015); The Authors (2016-present)
To define the tangential tractions generated by epiretinal membranes in lamellar macular holes.
Three different categories of tangential traction associated with epiretinal membranes were previously defined:-unidirectional (folds directing to a center of traction not in the fovea),-pluridirectional (more centers of traction with different directions of folds)-concentric (all folds directing to the center of the fovea).All patients included had a diagnosis of lamellar macular hole after fundus autofluorescence (FAF), infrared (IR) and spectral domain optical coherence tomography (SD-OCT) imaging (HRA+OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany). OCT examination included a macular map (193 B-scan, 30X20°pattern size and 31 µm distance between B-Scan). Two independent (masked) physicians evaluated the images in order to categorize the type of tangential traction either with IR and OCT (en-face) for every single patients. Cohen’s K statistic was used to evaluate inter-observers and inter-instruments agreement.
15 eyes of 14 patients were included in the study. Inter-OCT test showed perfect agreement between observers (k=1). Two membranes were defined concentric, 3 pluridirectional, 6 unidirectional and 4 frames were not classified by both examiners. Inter-IR test showed substantial agreement (K=0,7). One membrane was defined concentric for observer 1 and pluridirectional for observer 2, two frames were defined unidirectional for observer 1 and pluridirectional for observer 2. Inter-instruments agreement was poor for both observers, respectively k=0,08 for observer 1 and k=0,10 for observer 2.
Tangential traction associated with epiretinal membranes can be evaluated by OCT en-face and IR. Inter-observers concordance is high for both instruments. High inter-instruments discordance is present. Therefore, OCT en-face and IR imaging do not represent the gold standard for differentiating the different types of contraction of epiretinal membranes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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