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Paolo Corazza, Daniele Ferrari, Matteo Badino, Silvio Lai, Carlo Enrico Traverso; Anatomo-functional retinal changes after peeling and no peeling of the ILM. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4676. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze functional and anatomical different outcomes in patients affected by idiopatic epiretinal membrane (iERM) undergoing pars plana vitrectomy (PPV) 25 Gauge with and without ILM peeling.
This is a single center study. Patients affected by iERM were randomized in two groups: PPV associated with ILM peeling (Double Peeling group DP; n=10) and PPV without ILM peeling (Single Peeling group SP; n=10). A complete ophthalmological examination and best-corrected visual acuity (BCVA) evaluation by ETDRS charts were performed. Retinal sensitivity and microperimetric parameters were tested by MP1 microperimetry. Anatomical outcomes were analyzed with swept source optical coherence tomography (ss-OCT). One year after surgery Optical Coherence Tomography Angiography (OCTA) was performed. The scan of the superficial and of the deep capillary plexus was than elaborated by ImageJ software.
After a 6 month follow-up, BCVA improved in all patient with no difference between the two groups (p = 0.671). A significant (p = 0.019) postoperative difference was observed in mean retinal sensitivity in the 4° central area . The distance between fovea and disc margin was decreased in the SP group (p = 0.007). Fixation index was also evaluated by the central dominance percentage. SP group showed an average improvement of 38.3% ± 20.56%, whereas DP group had a mean improvement of 8.4% ± 16.87% (p=0.002). OCTA showed mean FAZ of 0.215 mm2 ± 0,058 and 0,112 mm2 ± 0,013 in the SP and DP group respectively. The difference in FAZ measurement between groups is statistically significant (P < 0.001) in the superficial plexus only. There is no statistically significant difference in the foveal vessel density of deep plexus between groups (P=0.417).
In terms of improvement of visual acuity both surgical practices are effective. Mean retinal sensitivity in 4° central area and central fixation stability significantly improved more in patients treated with the SP technique. OCTA might become a useful tool for preoperative and postoperative evaluation of epiretinal membrane.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Fig.1:Angio OCT of patients of single peeling group and the ImageJ modified image
Fig.1:Angio OCT of patients of double peeling group and the ImageJ modified image
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