Morphological, phisiological and immunocytochemical evaluation in patients with idiopathic epiretinal membranes

Abstract

PurposeTo investigate changes of the vitreoretinal interface in patients with idiopathic epiretinal membranes (ERM).MethodsAnalysis of 23 patients treated by 25G PPV due to visual imparment caused by idiopathic ERM. BCVA and DRI OCT (Atlantis Topcon) imaging was performed before surgery and in one year follow up. Retinal and vitreoretinal interface morphology was evaluated and compared with changes in visual fuction. ERM and internal limiting membranes (ILM) were collected intraoperatively for immunocytochemical analysis. Photographeis of probes were made by scanning confocal microscope LSM 88‐ Zeiss, with seven laser lines, 32‐channel spectral detector GaAsP and two photomultiplier for fluorescence and one for transmission. Scanning module was connected with reverse optic microscope Axio Observer Z1 Zeiss with fluorecsent lamp and adequate filters.ResultsBCVA before surgery was from counting finger from 3 m to 0.5 (mean 0.1) and in one year of postoperative follow up ipmroved to 0.3–0.9 (mean 0.6). In 18 eyes (78%) vitreoretinal traction was visualized by OCT DRI before the surgery. Mean central retinal thickness (CRT) was 487 μm. In patients with CRT more than 500 μm macular oedema in preoprative scans was observed. In these cases the oedema was reduced in one year of postoperative observation. Microscopic and immunocytochemical analysis revealed a high amount of cells in ERM probes and low number of cells in ILM probes (immunoreactivity was positive for glial cells, retinal pigment epithelium, hyalocytes, actin and macrophages).ConclusionsNew techniques of visualisation and analysis improve possibilities of diagnostic and evaluation of treatment results in patients with ERM. These methods should be used as complementary. Evaluation of wider group of patients may improve the knowledge in the field of idiopathic ERM etiopathogenesis.