Purchase this article with an account.
John Charles Zeyer, Paul R Parker, Mathew MacCumber; Optical Coherence Tomography Features as Pre-operative predictors of Post-operative Visual Improvement in Patients Undergoing Epiretinal Membrane and Internal Limiting Membrane Peeling. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1099.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate features of macular appearance on pre-op OCT as predictive indicators of post-op visual recovery following internal limiting membrane (ILM) peeling surgery for visually significant epiretinal membrane (ERM) to aid in pre-op stratification of patients.
A retrospective chart review of 66 eyes in 66 patients at Illinois Retina Associates who underwent pars plana vitrectomy for ERM in the year 2015. Patients with confounding vascular or vitreomacular interface conditions distinct from an ERM were excluded. Inclusion criteria required a pre-op visual acuity of at least 20/200 and minimum follow up of one year. For each patient change from baseline visual acuity at one-year follow up was calculated. The following features on pre-operative OCT were recorded: ellipsoid zone disruption, intraretinal cysts, surface striae/corrugations, lamellar holes, central thickness, and a “domed” or “flat” foveal contour.
Patients with a “domed” configuration of the inner retinal contour pre-operatively had a mean pre-op acuity of 20/70 (LogMAR 0.54) and experienced a mean of 2.4 lines gained at one year, as opposed to those with a “flat” inner retinal contour who had a mean pre-op acuity of 20/60 (LogMAR 0.49) and a mean of 0.6 lines gained (p=0.02). Additionally, the differences in mean vision gain between the following subgroups of patients were less dramatic: those with intraretinal cysts versus those without (2.6 lines vs. 1.5 lines, p=0.08), those with surface striae versus those without (1.8 lines vs. 2.8 lines, p=0.23), and those with central thickness greater than 450 um versus those with central thickness less than 450 um (2.4 lines vs. 1.6 lines, p=0.25). There were an insufficient number of eyes included for comparison that had ellipsoid zone disruption on pre-op OCT (4).
The morphology of the inner macula, i.e. either domed or flat, may be of prognostic value when pre-operatively assessing a patient’s potential for visual recovery following ERM/ILM peeling surgery. The other OCT features studied failed to demonstrate additional predictive value pertaining to post-op visual recovery. However, a larger and higher powered study will likely be required to confirm these findings.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Macula OCT showing an ERM, a domed contour, surface corrugations, and an intraretinal cyst.
This PDF is available to Subscribers Only