Abstract

Background: Idiopathic epiretinal membrane (iERM) is a common eye disease, which can be treated by surgical removal of the fibrotic tissue. Morphological outcome is generally evaluated by optical coherence tomography (OCT). Here, we investigate the impact of surgery on hemodynamics of the posterior pole, using OCT angiography (OCTA). Methods: Patients with unilateral iERM and indication for treatment were included. OCT and OCTA images of the posterior pole were obtained preoperatively and 3-months after 23G vitrectomy with membrane peeling. Parameters of interest included full retinal perfusion, choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP), and Haller’s layer perfusion, which were evaluated longitudinally and also compared to unaffected fellow eyes. Using these parameters, multiple regression analyses were used to predict visual outcomes. Results: Sixty-three iERM eyes were recruited, which initially showed a significant bigger central retinal thickness (p < 0.001) and total macular volume (TMV) (p < 0.001) compared to fellow eyes, while perfusion parameters were alike. Three months later, treated eyes had a statistically significant thicker subfoveal choroid (p = 0.006) and showed an increase of CCP (p = 0.003), while SLP decreased (p = 0.014). Lower preoperative TMV and higher SLP were associated with better postoperative visual outcome. Conclusion: In this OCTA study, iERM itself does not affect the choroidal circulation. However, preoperative choroidal circulation will be a biomarker to know the influence on the choroidal circulation after ERM surgery and may be considered as a predictor for visual outcome.

Highlights

  • Idiopathic epiretinal membrane is a common macular disease in elderly people, characterized by fibrocellular tissue proliferation along the surface of the internal limiting membrane (ILM) [1]

  • We investigate the impact of surgery on hemodynamics of the posterior pole, using optical coherence tomography (OCT) angiography (OCTA)

  • With the recent development of optical coherence tomography angiography (OCTA), the retinal and choroidal vascular network can be assessed in vivo and in real time by creating slab-segmented angiograms, without the need for dye injection [6,7,8]

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Summary

Introduction

Idiopathic epiretinal membrane (iERM) is a common macular disease in elderly people, characterized by fibrocellular tissue proliferation along the surface of the internal limiting membrane (ILM) [1]. A few studies have evaluated vascular changes due to ERM formation and ERM removal by using OCTA, focusing especially on retinal microvascular impairment [9,10,11,12,13]. Idiopathic epiretinal membrane (iERM) is a common eye disease, which can be treated by surgical removal of the fibrotic tissue. OCT and OCTA images of the posterior pole were obtained preoperatively and 3-months after 23G vitrectomy with membrane peeling. Parameters of interest included full retinal perfusion, choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP), and Haller’s layer perfusion, which were evaluated longitudinally and compared to unaffected fellow eyes. Using these parameters, multiple regression analyses were used to predict visual outcomes. Preoperative choroidal circulation will be a biomarker to know the influence on the choroidal circulation after ERM surgery and may be considered as a predictor for visual outcome

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