July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Internal limiting membrane peeling to prevent epiretinal membrane growth after retinal detachment repair: retinal surface wrinkling as a sign of proliferation
Author Affiliations & Notes
  • Kunihiko Akiyama
    Ophthalmology, National Hospital Organization, Tokyo Medical Center, Meguro-ku, TOKYO, Japan
    Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
  • Ken Watanabe
    Ophthalmology, National Hospital Organization, Tokyo Medical Center, Meguro-ku, TOKYO, Japan
    Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
  • Masaki Fukui
    Ophthalmology, National Hospital Organization, Tokyo Medical Center, Meguro-ku, TOKYO, Japan
    Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
  • Kaoru Fujinami
    Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
    Ophthalmology, National Hospital Organization, Tokyo Medical Center, Meguro-ku, TOKYO, Japan
  • Kazushige Tsunoda
    Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
    Ophthalmology, National Hospital Organization, Tokyo Medical Center, Meguro-ku, TOKYO, Japan
  • Toru Noda
    Ophthalmology, National Hospital Organization, Tokyo Medical Center, Meguro-ku, TOKYO, Japan
    Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
  • Footnotes
    Commercial Relationships   Kunihiko Akiyama, Alcon Pharma (R), Bayer Japan (R), Santen pharmaceutical (R), Senju Pharmaceutical (F); Ken Watanabe, None; Masaki Fukui, None; Kaoru Fujinami, Astellas Pharma (F), Kubota pharmaceutical (C); Kazushige Tsunoda, None; Toru Noda, Alcon pharma (R), Hoya (F), Kowa (R), Leica Microsystems (R), Novartis pharma (F), Santen Pharmaceutical (F), Topcon (R)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5764. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Kunihiko Akiyama, Ken Watanabe, Masaki Fukui, Kaoru Fujinami, Kazushige Tsunoda, Toru Noda; Internal limiting membrane peeling to prevent epiretinal membrane growth after retinal detachment repair: retinal surface wrinkling as a sign of proliferation. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5764.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Internal limiting membrane (ILM) peeling has been reported to prevent epiretinal membrane (ERM) growth after rhegmatogenous retinal detachment (RRD) repair; however, its indication is still controversial. We hypothesized that fine retinal surface wrinkling (RSW), sometimes observed on the attached macula of eyes with RRDs, is a sign of postsurgical ERM growth and conducted a prospective, interventional clinical study to select relevant cases for ILM peeling.

Methods : Thirty-nine consecutive cases (mean age: 56.5 years) undergoing vitrectomy for RRDs were assessed prospectively. Inclusion criteria were primary vitrectomy for RRDs and a follow-up period for 6 months. Exclusion criteria were RRDs involving the whole area in the vascular arcade, pre-existing macular disorders, RRDs with macular holes and proliferative vitreoretinopathy (PVR) formation, since RSW was distinguished from PVR grade B in this study. OCT images were obtained at each visit. During vitrectomy, the macula was observed extensively using a magnifying contact lens. Residual vitreous cortex, if present, was peeled-off facilitated with triamcinolone acetonide. Presence of RSW was assessed carefully both on intra-operative observation and pre-operative OCT. As the surgical intervention, ILM was peeled if RSW was present in the posterior pole. Outcomes were measured with the prevalence of post-surgical ERM growth with/without visual loss. Best-corrected visual acuities (BCVAs) at baseline and 6 months were converted to logarithm of minimum angle of resolution (logMAR) and compared between ILM-peeled cases (Group 1) and ILM-not-peeled cases (Group 2) to assess the safety of this procedure (Mann-Whitney U-test).

Results : There were 11 cases with RSW (28.2 %; Group 1, ILM-peeled) and 28 cases without RSW (71.8%; Group 2, ILM-not-peeled). ERM with visual loss developed in no case (0.0 % in both groups) post-surgically. Slight ERMs without visual loss were observed in 4 cases (10.3 %) of Group 2 at 6 months. BCVA was maintained at 20/25 or better in these 4 cases. BCVAs in Group 1/Group 2 at baseline and 6 months were 0.96±0.96/0.40±0.72 (p=0.124) and 0.14±0.24/0.001±0.17 (p=0.124) in logMAR, respectively.

Conclusions : ILM peeling based on presence of RSW prevented visual loss caused by post-surgical ERM growth with favorable visual outcomes during 6-months follow-up.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×