Abstract
Purpose :
Internal limiting membrane peeling (ILMP) is a common part of vitrectomy surgery for epiretinal membrane (ERM) or macular hole (MH). However, safety concerns remain since changes in macular thickness and vascular flow have been reported following ILMP. This retrospective study compared the macular morphology and flow following surgical ILMP when compared to the contralateral normal eye.
Methods :
We identified 62 patients who had undergone ERM or MH surgery in one eye with normal contralateral eye and follow-up of at six months postoperatively. Optical coherence tomography (OCT) was used to measure central subfield thickness (CST), mean cube thickness (MCT) and macular volume (MV) in both eyes at pre and post-perative visits. In a subset of eyes with OCT angiography (OCTA) performed postoperatively, vascular density (VD) in the 3x3mm foveal and parafoveal regions of the superficial, deep and full vascular slabs was obtained from the most recent image. Paired Student t test was used to compare means (p-value<0.05 statistically significant).
Results :
Among 62 patients, 44 had ERM surgery (35 with ILMP) and 18 had MH surgery (all with ILMP). Mean follow-up was 106.7 weeks (range 46.8-266.4 weeks). All operated eyes had significant reduction in CST, MCT and MV postoperatively. Among eyes that had ERM surgery with ILMP, mean CST, MCT and MV were 355um, 305um, and 9.6 mm3 respectively, while that for the contralateral eyes were 267um, 252um, and 9.0mm3 respectively (p value=2.33E-9, 1.82E-4, 0.01 respectively) at last postoperative visit. Among MH eyes, the operated eyes had mean CST, MCT and MV of 312um, 274um, and MV 9.05 mm3 respectively, while that for the contralateral eyes were 236um, 252um, and 9.1mm3, respectively (p value=0.01E-1, 0.03, 0.43 respectively). Postoperative OCTA was available in 10 eyes that had ILMP. No statistically significant difference was noted in the VD between the operated and contralateral eyes in the superficial, deep and full vascular slabs at the parafoveal and foveal regions.
Conclusions :
Although eyes with ERM and MH had reduction in macular thickness and volume following vitrectomy, ILMP was not associated with reduction in macular thickness, volume or perfusion when compared to the contralateral normal eye in this limited retrospective study.
This is a 2021 ARVO Annual Meeting abstract.