June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Giant internal limiting membrane tears in eyes with a visually significant epiretinal membrane undergoing pars plana vitrectomy with internal limiting membrane peeling
Author Affiliations & Notes
  • Robert A Hyde
    Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
  • Asad Farooq Durrani
    Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
  • Mark W Johnson
    Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
  • Footnotes
    Commercial Relationships   Robert Hyde, None; Asad Durrani, None; Mark Johnson, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4384. doi:
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    • Get Citation

      Robert A Hyde, Asad Farooq Durrani, Mark W Johnson; Giant internal limiting membrane tears in eyes with a visually significant epiretinal membrane undergoing pars plana vitrectomy with internal limiting membrane peeling. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4384.

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

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Abstract

Purpose : We report a seldom discussed clinical entity in eyes with an epiretinal membrane (ERM), which we call giant internal limiting membrane (ILM) tears. A giant ILM tear is defined herein as a prominent scrolled edge of ILM between the ERM and an area of ILM dehiscence. We sought to characterize the incidence, clinical characteristics, and optical coherence tomography (OCT) features of patients with and without giant ILM tears who underwent surgical repair for visually significant ERMs.

Methods : We conducted a retrospective chart review of patients with ERMs who underwent surgery with a single vitreoretinal surgeon at the University of Michigan Kellogg Eye Center (Ann Arbor, Michigan). Demographic information, preoperative, intraoperative and postoperative clinical data were collected from the patients' medical records. ERMs and giant ILM tears were identified from macula OCT and near-infrared fundus images. Data, image and statistical analysis were carried out in Excel (Microsoft) and MATLAB (Mathworks). The study was approved by the Institutional Review Board (IRB) of the University of Michigan.

Results : Giant ILM tears were present in 30.4% (n = 21) of all (n = 69) eyes with an ERM included in the analysis. Eyes with an ERM and giant ILM tear were significantly more likely to have high myopia (33.3%) compared to eyes without high myopia (8.3%, OR = 5.5, 95% CI [1.40-21.60], p = 0.015). There was no association between age, gender, preoperative visual acuity, preoperative central retinal thickness, or presence of posterior vitreous detachment and giant ILM tears (p > 0.05). Radial OCT scans identified giant ILM tears in the preoperative images in an additional 26.7% of eyes with ERM that did not appear to have such tears present on horizontal or vertical scans.

Conclusions : Giant ILM tears are encountered in patients with epiretinal membrane undergoing surgical repair and are more frequent in patients with high myopia. Careful preoperative assessment of these tears using radial OCT images may assist in their identification. The vitreoretinal surgeon may consider using a giant ILM tear to initiate ERM peeling to minimize macular trauma during surgery. Surgeons who do not routinely peel ILM at the time of ERM removal may wish to do so when giant ILM tears are present.

This is a 2020 ARVO Annual Meeting abstract.

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