Abstract
Purpose :
To assess long term anatomical and functional outcomes of epiretinal membrane (ERM) peel surgery in stage 3 ERM pseudophakic eyes that may guide preoperative surgical planning.
Methods :
A retrospective chart review was conducted on 725 charts from January 1, 2015-December 1, 2023 within a Midwest multicenter retina practice. 16 stage 3 ERM pseudophakic eyes that underwent uncomplicated membrane peel and at least 1 year of follow up were selected. Optical Coherence Tomography (OCT) scans and Best Corrected Visual Acuity (BCVA) were analyzed by masked graders preoperatively, at 3 months, 6 months, 12 months, 2 years, and last documented follow up. ImageJ (National Institutes of Health, USA) was utilized for anatomic measurements. ERM stage and presence of Ectopic Inner Foveal Layers (EIFL) were classified according to Govetto et al (2017). This study was approved by the Rush University Medical Center Institutional Review Board.
Results :
Mean follow up for selected eyes was 54.8 months. Anatomic outcomes were remarkable for improvement in ERM stage (37.5% of eyes), reduction of layers within EIFL (78.5% of eyes), and reduction in the thickness of EIFL (19.28 µm, 65.3% average reduction). Average final logmar BCVA displayed a significant improvement from preoperative measurements (20.1%). Preoperative EIFL thickness and layers within EIFL showed no statistically significant correlation with final BCVA (p=0.21, p=0.43, respectively). Preoperative BCVA was correlated with postoperative BCVA (p<0.05).
Conclusions :
Stage 3 epiretinal membranes have anatomic characteristics that may make their postoperative outcomes more difficult to predict. Although our isolation and analysis of stage 3 ERMs in the long term show no clear preoperative predictive signs of functional outcomes, significant improvement in anatomic outcomes may play a role in postoperative long-term outcomes. Further study may be required to determine the role of these anatomic changes in functional outcomes of epiretinal membrane surgery.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.