Abstract
Purpose :
To study foveal movement after 23G pars plana vitrectomy (ppVE) and ERM/ILM peeling in eyes with iERM and its association with best-corrected visual acuity (BCVA), central retinal thickness (CRT) and ILM peeling size.
Methods :
32 eyes of 32 patients with iERM undergoing ppVE and ERM/ILM peeling were evaluated before surgery and 1 day, 1 week, 1 month and 3 months after surgery. The following parameters were obtained: 4m ETDRS BCVA, intraoperative fundus photography (iFP). Spectralis enhanced-depth imaging (EDI) optical coherence tomography (OCT) with the papillofoveal distance (PFD) measured using the caliper function of the OCT system. The horizontal shift of the fovea (EFh) was measured in relation to the baseline OCT image. The vertical interscan distance (120µm) was used to determine the extent of the vertical shift (EFv). Pythagorean theorem was then used to calculate the length of the movement vector (EF). Peeling size in relation to the optic disc was evaluated on iFP images.
Results :
The mean reduction of the PFD after 3 months was 250,79µm in the study eye and 10,37µm in the fellow eye. (p<0.001). EF at month 3 correlated significantly with baseline CRT (p=0.03) and the change in CRT from baseline to month 3 (p=0.02). EF at week 1, month 1 and month 3 correlated with the change in CRT at week 1 (p=0.02), month 1 (p=0.03) and month 3 (p=0.02) respectively. EF after 3 months showed a significantly negative correlation with baseline BCVA (p=0.01). The change in PFD from baseline to month 3 did not correlate with the ILM peeling area.
Conclusions :
We showed for the first time that ppVE combined with ERM/ILM peeling for the removal of iERM leads to a decrease in the PFD. Our results indicate that this movement is independent from the ILM peeling size, but
foveal movement (EF) is correlated with baseline BCVA, baseline CRT and changes in CRT.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.