Abstract
Background: The tangential traction by idiopathic epiretinal membrane (iERM) may alter the hemodynamics of the macula. We investigated the correlation between visual acuity and the optical coherence tomography angiography (OCTA) parameters in unilateral iERM. Methods: We included 61 eyes of 61 consecutive patients with unilateral iERM between January 2018 and December 2018. The flow area of the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and choroidal capillary plexus (CCP) were measured using OCTA. The normal fellow eyes were used for comparison. The iERM patients were divided into those with a presence of foveal concavity and those with a loss of foveal concavity. Results: When compared with fellow eyes, the flow areas showed a statistically significant decrease in the SCP and CCP of those with iERM (p = 0.037 and p = 0.011, respectively). In the DCP, no significant reduction in flow area was found in iERM (p = 0.054). The flow area of the CCP was the only factor significantly associated with best vision (p = 0.012). No significant differences in the flow areas of the SCP, DCP, and CCP were found between the presence and loss of foveal concavity. Conclusions: The flow area of the CCP is an important determinant of vision, emphasizing the crucial role of choroidal circulation in iERM. Moreover, mechanical stretch by iERM is not the only mechanism affecting the flow area.
Highlights
Idiopathic epiretinal membrane is a common macular disease, occurring in approximately 4% to 10% of the general population, and its prevalence increases with age [1,2]
The study design was approved by the Institutional Review Board of Taipei City Hospital, and the study adhered to the tenets of the Declaration of Helsinki. idiopathic epiretinal membrane (iERM) was diagnosed based on the presence of a fibrous membrane in front of the macula, as visible on fundus examination using a 90 dpt lens, and was confirmed with Optical coherence tomography (OCT)
We found that the flow area of the superficial capillary plexus (SCP) and choroidal capillary plexus (CCP) in ERM eyes had a statistically significant decrease, while that of the deep capillary plexus (DCP) had a marginally significant decrease compared with normal fellow eyes
Summary
Idiopathic epiretinal membrane (iERM) is a common macular disease, occurring in approximately 4% to 10% of the general population, and its prevalence increases with age [1,2]. The contractile properties of iERM may exert traction on the retina that may cause variable loss of visual acuity and metamorphopsia [3,4,5]. The tangential traction by idiopathic epiretinal membrane (iERM) may alter the hemodynamics of the macula. Results: When compared with fellow eyes, the flow areas showed a statistically significant decrease in the SCP and CCP of those with iERM (p = 0.037 and p = 0.011, respectively). In the DCP, no significant reduction in flow area was found in iERM (p = 0.054). No significant differences in the flow areas of the SCP, DCP, and CCP were found between the presence and loss of foveal concavity. Conclusions: The flow area of the CCP is an important determinant of vision, emphasizing the crucial role of choroidal circulation in iERM. Mechanical stretch by iERM is not the only mechanism affecting the flow area
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