PurposeTo present microvascular changes in fovea following pars plana vitrectomy for idiopathic epiretinal membrane (ERM). Optical coherence tomography angiography (OCTA) was performed preoperatively and postoperatively.MethodsEleven patients diagnosed with idiopathic epiretinal membrane were enrolled in the study. OCTA was conducted before and 6 months after internal limiting membrane (ILM) peeling and pars plana vitrectomy performed by the same vitreoretinal surgeon. Foveal avascular zone (FAZ) and foveal vessel density (VD) in superficial capillary plexus were estimated by OCTA preoperatively and 6 months postoperatively. Contralateral healthy eye of the same patient served as controls.ResultsSuperficial FAZ preoperatively was significantly smaller in eyes with ERM compared to that of healthy eyes. Six months postoperatively, a significant increase in FAZ was observed, without reaching the levels of the FAZ of fellow healthy eyes. Foveal VD was significantly increased in eyes with ERM, whereas 6 months postoperatively a decrease of VD was observed. Greater differences in FAZ between the eye with ERM and the healthy control eye of the same patient as well as smaller FAZ were associated with worse best‐corrected visual acuity (BCVA) postoperatively.ConclusionsOCT angiography has been proven recently a noninvasive and useful tool for many foveal vascular lesions. In our case series, it showed foveal microvascular and morphological changes following surgical repair of epiretinal membrane with ILM peeling. There seems to be a significant association between these microvascular changes and visual prognosis.

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