Diagnostic and postoperative evaluation: application of new imaging modalities

Abstract

AbstractThe diagnosis of epiretinal membranes is clinical following a thorough history and fundus assessment. This lecture focuses however on additional imaging modalities currently available to facilitate the diagnostic and postoperative evaluation. Multicolour fundus imaging or confocal infrared imaging have provided superior ERM detection in comparison to fundus photography in mild cases. Diagnostic evaluation with OCT allows the estimation of retinal deformity due to the membrane, determines the involvement of the fovea and, with en‐face OCT, allows for the estimation of the membrane extent and dynamic development. High resolution OCT allows for the classification of epiretinal membranes to conventional or atypical. Specific retinal features have been identified in symptomatic eyes (macropsia). OCT imaging has allowed the determination of the ERM profile for specific categories of patients as patients with uveitis or concurrent diabetic macular oedema. Imaging following ERM peeling allows the estimation of anatomic and functional outcomes. OCT allows the qualitative and quantitative assessment of central macular thickness or individual retinal layers. Additional retinal features, some of which could have prognostic implications such as features of retrograde maculopathy, can be identified. Pre‐ and postoperative macular vascular circulation can be evaluated with the use of OCT‐A and evaluation of retinal oxygen saturation can be evaluated with the use of retinal oximeter. The features of the FAZ postoperatively have been investigated and have been associated with the degree of visual recovery. The impact of artefacts in this modality need to be taken into account.