Abstract
Purpose :
We previously reported that ILM folds around ERM showed typical radiating hyporeflective lines pattern from margin of ERM, and they were shown excellently on both red-free image of confocal scanning laser ophthalmoscopy (cSLO) and 3D-rendering image of optical coherence tomography (OCT). In this study, we focused on ILM folds underneath ERM and assessed its prevalence, morphologic characteristics, and clinical Implications, which was not reported previously.
Methods :
Retrospective, observational case study was performed in fifty five eyes of 48 patients with ERM. We developed a novel method of obtaining image of ILM folds underneath ERM. Using en face analysis mode of standard OCT macular volume scan, topographic surface images of ILM folds were acquired, then by adjusting frontal surface scan line, images of ILM folds situated underneath ERM and around ERM was acquired, respectively. We classified patterns of ILM folds underneath ERM group and compared them to those around ERM group. The prevalence of each patterns of ILM folds were obtained and compared between the two groups. In the patients with follow-up periods >5 years, anatomical & functional ERM progression was matched to that of the ILM fold patterns.
Results :
Pattern of ILM folds were classified as radiating, irregular-random oriented and mixed. Among the 55 eyes, ILM folds around ERM group showed 52 (94.5%) eyes of radiating, 2 (3.6%) eyes of irregular and 1 (1.8%) of mixed pattern. Notably, ILM folds underneath ERM group showed 10(18.2%) eyes of radiating, 30 (54.5%) of irregular, 15 (27.2%) of mixed pattern. Irregular, random oriented pattern of underneath ERM group is composed of multiple gaps between ERM and retina. Immediately after ERM with ILM peeling, the ILM fold disappeared in both group of all eyes. ERM progression showed excellent agreement with ILM fold progression (kappa value [κ]= 1.0, 0.8, respectively in each group).
Conclusions :
Our novel images using standard OCT showed that ILM folds underneath ERM has a random oriented, irregular pattern, which is remarkably different from typical radiating ILM folds around ERM. Particularly, this overview of ILM folds and gaps between ERM and retina provides us pre-surgical information and may aid to predict visual prognosis.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.