Retinal structural changes before and after idiopahic epiretinal membrane peeling – a study using OCT segmentation

Abstract

PurposeWe aim to study the microstructural changes and thickness of inner retinal layers in patients with idiopathic epirretinal membranes treated with peeling.MethodsObservational retrospective study that included patients treated for idiopathic epiretinal membrane. Visual acuity and central retinal layers thickness were recorded before and at the last follow up visit. The retinal layers thickness was given by automated segmentation of OCT Heidelberg Spectralis but the accuracy was verified and when in disagreement, manual correction of the segmentation was made and the new measured thickness was used. 33 patients were treated with combined fhacoemulsification.and peeling and 14 patients had only peeling of the epiretinal membrane with vitrectomy.Results47 eyes of 46 patients were included with a mean age of 73.44 years. There was a significant improvement of visual acuity from 0.3 ± 0.1 to 0.6 ± 0.2 (p < 0.0001). From the tomographic analysis,was noted a significant reduction in the mean central macular thickness (CMT) from 469.4 ± 97.74 to 397.8 ± 71.16 (p < 0.0001), in the retinal nerve fiber layer (RNFL) thickness from 51.2 ± 49.84 to 24.71 ± 23.21 (p < 0.0001), in the ganglion cell layer (GCL) thickness from 55.4 ± 25.22 to 39.2 ± 13.08 (p < 0.0001), in the internal plexiform layer (IPL) thickness from 46.31 ± 13.46 to 38.62 ± 13.62 (p = 0.0012), in the outer plexiform layer (OPL) thickness from 39.71 ± 9.04 to 34.38 ± 7.9 (p = 0.0016) and in the internal retinal layers (IRL) thickness from 384.5 ± 97.7 to 312.8 ± 70.8 (p < 0.0001). There was no statistical difference in the thickness of the outer retinal layer, outer nuclear layer and inner nuclear layer before and after membrane peeling.ConclusionsThe layers that most have changed and contributed to the reduction of central thickness treated with peeling were the Internal Retinal Layers: RNFL, GCL and IPL.