Abstract
Purpose :
To compare different types of pre-operative imaging and intraoperative visualization after staining in the analysis of primary epiretinal membrane (ERM) morphology.
Methods :
Consecutive patients operated on for ERM with pre-operative multimodal imaging over a 9-month period were retrospectively reviewed. Secondary ERM and cataract combined procedures were excluded. Pre-operative imaging consisted in color retinophotography, a 55° Infrared reflectance (IR) and blue reflectance (BR) and a macular cube spectral domain optical coherence tomography (OCT) with En Face analysis. Intraoperative visualization of the ERM after 1-min staining with a mix of trypan blue and brillant blue was captured. For each patient, the 5 images obtained were sorted by 2 independent specialists from A to E by order of contribution in the analysis of ERM morphology and limits (A being the most contributive image, E the less). The most contributive image was the one gathering the higher rate of A+B.
Results :
On the 34 patients operated on for ERM, 13 were excluded because of combined surgery or secondary ERM. Eventually, 21 patients operated on for primary ERM were analyzed. Mean patient age was 70.4 years (± 9.2, range 53-87) and 48% of patients were phakic. The most contributive images were in that order: BR (A+B=69%), En face OCT analysis (A+B= 66.7%) and intraoperative visualization capture (A+B=61.9%). Color retinophotography (A+B=2%) and IR (A+B=0%) were the less contributive. Among phakic patients, BR offered the best analysis of the ERM morphology (A+B=85%), whereas in pseudophakic patients, the most contributive image was En face OCT (A+B=81.8%).
Conclusions :
Morphological analysis of ERM may benefit from a multi-modal pre-operative imaging, especially BR image and En Face OCT analysis. Their quality may depend on the lens status. Both images may be used as overlays in future digital visualization operating systems.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.