Epiretinal Membrane Research Articles

Idiopathic epiretinal membrane surgery with internal limiting membrane peeling: An optical coherence tomography angiography analysis of macular capillary plexus changes.

This study aims to assess retinal vascular changes following internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (ERM) treatment using optical coherence tomography angiography (OCT-A). A retrospective study was conducted. A cohort of thirty-nine patients was enlisted for this study. Each participant underwent comprehensive ophthalmological evaluation and OCT-A imaging at baseline, as well as at 1-month and 6-month intervals post-pars plana vitrectomy with ERM and ILM peeling. Post-surgery, remarkable improvements were observed in best-corrected visual acuity (BCVA) (from 0.335 ± 0.173 to 0.096 ± 0.126 at 6 months), coupled with a notable reduction in central retinal thickness (CRT) (from 460 ± 87 µm to 395 ± 53 µm at 6 months). Additionally, there was a noticeable expansion in the foveal avascular zone (FAZ) perimeter (from 0.099 ± 0.060 mm² to 0.125 ± 0.056 mm² at 6 months). However, there was a decline in vessel density (VD) in the superficial capillary plexus (SCP) (from 46.7 ± 4.4 to 43.8 ± 3.5% at 6 months), contrasted by an elevation in the deep capillary plexus (DCP) (from 45.2 ± 5.5% to 43.6 ± 5.3% at 6 months. Noteworthy correlations were detected between CRT and BCVA, as well as CRT and vascular parameters. ERM instigates a milieu of changes including SCP crowding and elevation, potentially leading to a falsely augmented density at OCT-A in affected patients. Subsequent surgery results in a release of ERM-induced forces, elucidating the observed decrease in SCP density. Conversely, the DCP appears to be less distorted by the ERM, facilitating gradual vessel reopening after its removal. OCTA provides valuable insights into optimal surgical timing.

Epiretinal Membrane and Senile Cataract: Combined vs Sequential Surgery.

To evaluate the outcomes of combined phacovitrectomy versus sequential phacoemulsification and vitrectomy in patients with both senile cataract and epiretinal membrane (ERM). A retrospective multicenter study was conducted between 2014 and 2022 at two hospitals in Italy. Patients with idiopathic ERM and senile cataract in the same eye were enrolled and underwent either combined (n=38) or sequential surgery (n=38), performed by a single surgeon. Best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at 1, 3, and 6 months after surgery. Both surgical approaches significantly improved BCVA and reduced CMT after 6 months. However, sequential surgery showed faster visual recovery, with significant improvements in BCVA (P=0.008) and CMT (P<0.0001) observed as early as 1-month post-surgery, compared to the combined group. Although both surgical approaches yielded significant improvements in visual acuity and central macular thickness at 6 months, the sequential approach offered a faster recovery in the early postoperative period. According to the literature, the sequential approach also allows some patients to be satisfied after cataract surgery alone, potentially avoiding unnecessary vitrectomy and reducing the risk of overtreatment.

Increased risk of cystoid macular edema after cataract surgery in eyes previously vitrectomized for idiopathic epiretinal membrane.

To assess the rate and risk factors of cystoid macular edema (CME) both after isolated vitrectomy and after subsequent phacoemulsification in eyes with primary non-complicated rhegmatogenous retinal detachment (RRD) or idiopathic epiretinal membrane (ERM). Retrospective observation of institutional patients undergoing vitrectomy for RRD or vitrectomy with internal limiting membrane peeling for ERM from 2016 to 2021, further analyzing those who later underwent phacoemulsification. The CME rate was assessed within the first 6 months after both vitrectomy and cataract surgery. We included 187 phakic eyes with ERM and 311 with RRD undergoing isolated vitrectomy. Post-vitrectomy CME occurred in 12.8% of ERM cases compared to 1% in RRD cases (p<0.0001). Stage-4 ERMs and intraoperative laser were found associated with CME. After uncomplicated phacoemulsification, the CME rate was higher in eyes vitrectomized for ERM (13.8%) compared to RRD (2%, p=0.0055). Post-vitrectomy CME was found to be associated with an increased risk of post-cataract CME (OR 13.588, p=0.0187). In eyes undergoing phacoemulsification post-vitrectomy, the risk of CME is higher when vitrectomy was performed for ERM compared to RRD. The ERM-related intraretinal changes, together with the required surgical stress, may play a role in making these eyes more susceptible to CME.

Clinical Characteristics and Surgical Outcomes of the Full-thickness Macular Hole Without Focal Vitreomacular Traction: A Multicenter Retrospective Study.

This study investigated the clinical features and surgical outcomes of full-thickness macular holes (FTMHs) without focal vitreomacular traction (VMT) and discusses possible underlying mechanisms. This was a retrospective observational study included patients aged 18 years or older with stage 2 FTMHs who underwent pars plana vitrectomy at three hospitals between December 2016 and March 2024. Patients diagnosed without focal VMT in the macula were classified as VMT- and those with focal VMT were classified as VMT+. Medical records and comprehensive ophthalmologic examinations, including best-corrected visual acuity (BCVA) and optical coherence tomography assessments, were reviewed. This study analyzed 94 eyes that underwent surgery for stage 2 MHs. Patients in the VMT- were younger (VMT- vs VMT+: 63.6 vs 69.1 years, P = 0.008), had a longer axial length (AL) (25.2 vs 24.0 mm, P = 0.004), and had better preoperative BCVA [0.41 (20/43) vs 0.66 (20/74) logMAR, P = 0.002 ] compared with the VMT+. The VMT- had a higher prevalence of epiretinal proliferation (EP) compared with the VMT+ (76 vs 5 %, P<0.001). Postoperatively, no significant difference in visual outcomes was found between the two groups . VMT- showed significantly thicker central retinal thickness at 1 month (244 vs 201 μm, P = 0.021) and poorer external limiting membrane status at 1 month compared with the VMT+. FTMHs without focal VMT were associated with younger age, longer AL, better baseline visual acuity, and a higher incidence of EP compared with FTMHs with VMT.

OPTICAL COHERENCE TOMOGRAPHY–BASED EPIRETINAL MEMBRANE STAGE CORRELATES WITH TANGENTIAL RETINAL DISPLACEMENT AND METAMORPHOPSIA

Purpose: To investigate correlations of the optical coherence tomography–based epiretinal membrane (ERM) classification with metamorphopsia and tangential retinal displacement after ERM surgery. Methods: ERM stage (stage 1–4) was defined as originally described. Metamorphopsia scores at baseline, 1 month, 3 months, and 6 months after ERM surgery were measured with M-CHARTS (Inami, Co, Tokyo). Tangential retinal displacement was measured as described previously. Eyes with retinal cysts, lamellar hole with epiretinal proliferation, or retinoschisis were excluded. Results: One hundred thirty-five eyes of 135 consecutive patients who underwent ERM surgery at a single academic hospital were enrolled. There were 20 eyes of stage 1, 57 eyes of stage 2, 54 eyes of stage 3, and 4 eyes of stage 4. Epiretinal membrane stage correlated with tangential retinal displacement at 1 month, 3 months, and 6 months postoperatively (Spearman rank correlation coefficient, P &lt; 0.001), which also correlated with both horizontal and vertical preoperative M-CHARTS scores (P &lt; 0.001) and horizontal scores at 1 month (P = 0.001) and 3 months (P = 0.016). Visual acuities did not show any correlations with the stage. Conclusion: Optical coherence tomography–based ERM classification correlates strongly with tangential retinal displacement after ERM surgery. This classification is particularly useful to predict pre- and postoperative metamorphopsia, but not for visual acuity.

Comparative proteomic analysis of human vitreous in rhegmatogenous retinal detachment and diabetic retinopathy reveals a common pathway and potential therapeutic target

BackgroundThe vitreous humor serves as a window into the physiological and pathological processes of the eye, particularly the retina. Diabetic retinopathy (DR), a leading cause of blindness, involves hyperglycemia-induced damage to retinal cells, leading to ischemia and elevated nitric oxide levels, culminating in vascular proliferation. Rhegmatogenous retinal detachment (RD) results from a break in the neuroretina, triggering ischemia, photoreceptor death, and cellular proliferation. Proliferative vitreoretinopathy (PVR) further complicates these conditions through fibrous proliferation. Despite their prevalence and potential for blindness, our understanding of the molecular mechanisms underlying these vitreoretinal diseases is incomplete.Methods and resultsTo elucidate disease mechanisms and identify potential therapeutic targets, we conducted a comparative proteomic analysis of vitreous samples from DR, RD, and macular pucker (P) patients, which were chosen as controls. LC–MS analysis identified 988 quantifiable proteins, with distinct clustering observed among disease groups. Differential expression analysis revealed 202 proteins in RD vs. P and 167 in DR vs. P, highlighting distinct proteomic signatures. Enrichment analysis identified glucose metabolism as an altered process in both diseases, suggesting common pathways despite differing etiologies. Notably, aldo–keto reductase family 1 member B1 (AKR1B1) has emerged as a potential key player in both DR and RD, indicating its role in glucose metabolism and inflammation. In silico drug screening identified diclofenac, an approved ophthalmic non-steroidal anti-inflammatory drug (NSAID), as a potential therapeutic agent targeting AKR1B1.ConclusionOur study revealed distinct proteomic signatures and common pathways in vitreoretinal diseases, highlighting AKR1B1 as a potential therapeutic target. Using diclofenac during diagnosis and postoperative care for diabetic retinopathy or rhegmatogenous retinal detachment may reduce complications, lower costs, and improve quality of life. Future research will focus on confirming AKR1B1’s role in vitreoretinal diseases and understanding diclofenac’s mechanism of action.

Anatomical, functional, and prognostic results of vitrectomy in epiretinal membranes secondary to retinal vein occlusions

Introduction: We investigated the anatomical and functional results of vitrectomy associated with the peeling of secondary epiretinal membranes (ERM) in patients with retinal vein occlusion (RVO) and determined the prognostic factors of surgical outcomes. Methods: This retrospective, multicenter, observational study included 50 patients with RVO who underwent vitrectomy with ERM removal between July 2012 and February 2021. Visual acuity (VA) and central macular thickness (CMT) were investigated up to three years. Univariate analysis identified the predictive factors associated with functional and anatomical outcomes. Results: Fifty eyes from 50 patients (62% with central RVO) were included. The mean VA of 0.9 ± 0.7 logMAR preoperatively improved to 0.5 ± 0.5 logMAR after 24 months (p=0.01). Anatomically, the mean preoperative CMT was 501 ± 168 μm, decreasing to 348 ± 108 μm at month 24 (p=0.008). By 36 months, VA had improved or stabilized in 90% of the eyes, whereas CMT had reduced by at least 20% from baseline in 80% of the eyes. A lower number of intravitreal injections (IVI) was required after vitrectomy. Worse preoperative VA, absence of preoperative pan-retinal photocoagulation, and postoperative use of adjunctive IVI were associated with VA recovery. Higher baseline CMT and the use of preoperative dexamethasone injections were associated with an improvement in CMT. Conclusion: Vitrectomy for ERM secondary to RVO was effective in improving VA and recovering CMT for up to 3 years and reduced the number of IVIs.

Peripapillary and Macular OCTA Predictors of Visual Improvement in Patients Treated with Vitrectomy for Idiopathic Epiretinal Membrane

Introduction: We investigated the changes of peripapillary and macular microvasculature in idiopathic macular epiretinal membrane (iERM) eyes before and after pars plana vitrectomy (PPV), aiming to identify potential optical coherence tomography angiography (OCTA) predictors of visual acuity improvement. Methods: Fifty-seven eyes diagnosed with iERM were enrolled and underwent PPV with ERM and Internal limiting membrane (ILM) peeling. Data were collected before surgery and during the twelve-month postoperative period. OCTA analysis focused on radial peripapillary capillary (RPC) vessel density (VD), superficial and deep capillary plexus (SCP and DCP, respectively). Functional, and OCT structural outcomes, including best-corrected visual acuity (BCVA) and macular thickness, were also recorded. Results: Multivariate linear regression analysis revealed that higher preoperative RPC VD, lower SCP VD, and lower BCVA were predictors of postoperative BCVA improvement (p&lt;0.001, p=0.047, and p&lt;0.001, respectively). Throughout the follow-up period, there was an observed increase in intradisc RPC VD, whole-disc VD, and parafoveal DCP VD (all p&lt;0.001). BCVA and central macular thickness (CMT) demonstrated significant improvement (p&lt;0.001) within the first month following vitrectomy, which then stabilized from the third month onwards. Conclusions: Preoperative microvascular measurements in iERM patients can forecast postoperative BCVA. OCTA findings reveal that both increased RPC density and reduced SCP density at baseline could serve as predictors of better visual outcomes after surgery. Enhanced RPC density may reflect a healthier optic nerve with greater potential for visual recovery, while a less dense SCP could indicate less iERM contraction, both contributing to more favorable postoperative visual results.

Risk factors and prognostic analysis of vitreous cavity opacification after silicone oil removal.

This study aims to investigate the risk factors for postoperative vitreous cavity opacification following pars plana silicone oil removal and its impact on prognostic visual acuity. A retrospective case-control study was conducted. A total of 66 eyes from 66 patients were enrolled in the study. On the first postoperative day, all patients underwent a scanning laser ophthalmoscopy to assess the turbidity of the vitreous cavity. 42.42% (28/66) were categorized as Grade 0, 36% (24/66) as Grade I, and 21% (14/66) as Grade II, based on the visibility of posterior pole blood vessels. Ordered multiple classification logistic regression analysis was employed to investigate the impact of surgical and baseline factors on the occurrence and severity of vitreous cavity opacification. The presence of high myopia and the intraoperative combination of epiretinal membrane peeling exhibited significant correlations with the development of postoperative vitreous cavity opacification (OR = 3.424, 95% CI 2.326-31.643, P = 0.023; OR = 3.612, 95% CI 1.263-14.676, P = 0.031, respectively). The best corrected visual acuity (BCVA) on the first day post-surgery was significantly reduced across all degrees of opacification compared to the preoperative level (p < 0.001). However, no significant difference in BCVA was detected between the preoperative period, one-week post-operation, and the last follow-up (P > 0.05). High myopia and intraoperative epiretinal membrane peeling may be associated with the development of more severe vitreous cavity opacity following silicone oil removal. This opacity generally resolves within one week post-surgery and does not appear to increase the risk of retinal re-detachment.

Decreasing outer retina traumatism of ILM peeling in diabetic eyes with foveal sparing technique.

To evaluate the effect on outer retina integrity of foveal sparing internal limiting membrane (ILM) peeling compared to standard ILM peeling on proliferative diabetic retinopathy (PDR) eyes affected by diabetic macular edema (DME) and epiretinal membrane (ERM). Eyes diagnosed with PDR, DME and ERM eligible for vitrectomy were prospectively recruited and randomly assigned to either foveal sparing (FS) group and no foveal sparing (nFS) group. Ellipsoid zone (EZ) lesion size, EZ reflectivity and external limiting membrane (ELM) integrity and angular sign of Henle Fiber Layer Hyperreflectivity (ASHH) were assessed preoperatively and 1 year postoperatively. Twelve (12) eyes and fifteen (15) eyes were included in FS and nFS group respectively. The two groups showed no differences in terms of EZ lesion size (p=0.549), EZ reflectivity (p=0.657) and ELM integrity (0.999) at preoperative examination. A significant increase in EZ lesion size was noted in nFS group between preoperative and postoperative examination (p=0.040) which was not present in FS group (p=0.862). Moreover, nFS group showed a higher prevalence of ASHH and a lower EZ reflectivity at follow up compared to FS group (respectively p=0.047 and p=0.041). Vitrectomy with FS ILM peeling may result in a better preservation of the Muller-photoreceptors complex in PDR complicated with DME and ERM.

Long-term risk factors for poor visual outcomes in patients with epiretinal membrane and open-angle glaucoma: a retrospective study

We aimed to identify prognostic risk factors for visual deterioration in eyes with epiretinal membrane (ERM) and open-angle glaucoma (OAG) through long-term follow-up. In this retrospective observational case series, we examined consecutive eyes with ERM and OAG over a minimum follow-up of 2 years. Visual outcomes and prognostic factors were analyzed in patients’ eyes undergoing ERM peeling with pars plana vitrectomy (PPV) (peeling group) and only observation (observation group). Eyes followed for less than 2 years after PPV were excluded. Among 100 eyes from 84 patients, 31 and 69 eyes were classified into peeling and observation groups, respectively. Over the follow-up period, best-corrected visual acuity (BCVA) in the observation group worsened from 0.03 ± 0.19 to 0.14 ± 0.33 (P = 0.0003), whereas that in the peeling group remained stable. Multivariate analysis revealed microcystic macular edema (MME) (odds ratio: 4.97; 95% confidence interval [CI]: 1.52 to 16.2; P = 0.008) and thin central foveal thickness (CFT) (odds ratio: 0.99; 95% CI: 0.98 to 1.00; P = 0.033) as risk factors for visual acuity decay. The presence of MME and thin CFT were risk factors for long-term visual deterioration in eyes with ERM and concomitant OAG. Vitrectomy with ERM peeling for eyes with OAG may be considered to preserve BCVA.

Comparison between spectral-domain optical coherence tomography-based and partial coherence interferometry-based biometry

We compared axial length (AL) measurements using spectral-domain optical coherence tomography (SD-OCT)-based and partial coherence interferometry (PCI)-based biometry in eyes with various chorioretinal diseases. Medical records were retrospectively analyzed in 123 eyes from 73 patients who underwent AL measurements using SD-OCT and PCI. AL values were highly consistent by both measurements (ICC = 0.996 in SD-OCT and 0.995 in PCI-based biometry). The mean difference in AL between the two instruments was − 0.09 ± 0.17 mm, which was significant (P < 0.001). There was a strong correlation between the measurements obtained using the two instruments (r = 0.982, P < 0.001). The 95% limits of agreement were − 0.43 to 0.25 mm, and the agreement of AL in the Bland–Altman analysis showed a difference. The difference in measurements was not associated with the difference in central retinal thickness (r = 0.033, P = 0.720). However, the presence of an epiretinal membrane affected the difference in measurements, unlike in other chorioretinal diseases (P = 0.014). SD-OCT-based biometry showed a good correlation with PCI-based biometry in the measurement of AL; however, the mean AL between the two instruments was significantly different. Therefore, AL measurements made using SD-OCT-based and PCI-based biometry are not interchangeable.

Relationship between macular microvasculature and visual function in idiopathic macular epiretinal membrane by using OCT angiography and multifocal electroretinogram

PurposeTo investigate the relationship between microvasculature and visual function in idiopathic epiretinal membrane (iERM). MethodsThis retrospective study included 30 iERM eyes. Macular microvasculature was evaluated by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Visual function was evaluated by best corrected visual acuity (BCVA) and multifocal electroretinogram (mfERG). All parameters were measured in the iERM patients at baseline, 1 month, and 3 months postoperatively. Associations between macular microvasculature and visual function were evaluated. ResultsBCVA, central retinal thickness (CRT) and parafoveal vessel density (PFVD) of the deep capillary plexus (DCP) changed significantly 3 months after surgery. P1 amp density and amplitude of ring 1 decreased significantly 3 months postoperatively. P1 implicit time of ring 1 was shortened after surgery. Baseline PFVD of DCP was negatively correlated with the postoperative BCVA, and baseline BCVA was positively correlated with the postoperative BCVA. Baseline foveal avascular zone (FAZ) and P1 amplitude of ring 1 were positively correlated with the postoperative P1 amplitude of ring 1 (p < 0.05). Multiple linear regression analysis revealed that baseline PFVD of DCP was a predictor of the postoperative BCVA, and baseline FAZ was a predictor of the postoperative P1 amplitude of ring 1 (p < 0.05). ConclusionAlthough visual acuity and CRT improved after iERM surgery, visual function estimated by mfERG had a limited recovery 3 months postoperatively. Baseline PFVD of the DCP and FAZ were predictors of visual function after the iERM surgery.

Clinical Profiles of Retinal Vasoproliferative Tumors.

Purpose: To describe the clinical features and treatment outcomes of patients with retinal vasoproliferative tumors. Methods: This retrospective case series comprised patients diagnosed with a retinal vasoproliferative tumor. Electronic medical records were reviewed, and patients' demographic details, clinical presentation, and treatment outcomes were analyzed. Results: Nineteen eyes of 19 patients with vasoproliferative tumors were included. The mean age (±SD) at presentation was 37.0 ± 16.95 years. No eye had bilateral tumors, and 1 eye had multiple tumors. Three eyes (15%) had primary tumors, while 16 (84%) had secondary tumors. Primary tumors mainly affected the inferotemporal quadrant (n = 3). Secondary tumors involved the inferior quadrant (n = 4), inferotemporal quadrant (n = 5), and inferonasal quadrant (n = 5). Secondary tumors were associated with Coats disease (n = 6), intermediate uveitis (n = 3), traumatic chorioretinopathy (n = 2), familial exudative vitreoretinopathy (n = 2), retinal vasculitis (n = 2), and retinal vascular occlusion (n = 1). Retinochoroidal features included intraretinal and subretinal exudates, subretinal fluid, intraretinal hemorrhaging, vitreous hemorrhaging, cystoid macular edema, vitritis, preretinal fibrosis, dilated feeding vessel, epiretinal membranes, and tractional retinal detachment. Treatment modalities included cryotherapy, laser photocoagulation, and local steroids. The mean follow-up was 25.3 months, during which 18 eyes had tumor regression and 1 had a worsening condition. Conclusions: Secondary vasoproliferative tumors were more frequently observed than primary tumors, often presenting as unilateral, unifocal tumors situated posterior to the equator in the inferior fundus. Conventional treatment approaches, such as cryotherapy and laser photocoagulation, were effective at tumor regression and often required multiple sessions.

INTERNAL LIMITING MEMBRANE PEELING IN CASE OF RHEGMATOGENOUS RETINAL DETACHMENT AS A PREVENTIVE MEASURE FOR EPIRETINAL MEMBRANE

Rhegmatogenous retinal detachment (RRD) is one of the general determinants of the primary sight disability. However, employable people represent the majority of patients with RRD.Over the past 50 years, retinal detachment surgery had rapid progress, and the rate of success surgery increased up to 90% and higher. However, reducing the risks of reoperations, improving functional outcomes and increasing postoperative visual acuity remain topical issues at present.The main reason for second surgical interventions is progression of the proliferative vitreoretinopathy, which can lead to epiretinal membrane, macular oedema, and to recurrence of the retinal detachment.We reviewed current literature studies that report the results of internal limiting membrane peeling in cases with RRD and other alternative techniques aimed at reducing the risk of mentioned above postoperative complications.

DYNAMICS OF MORPHOFUNCTIONAL PARAMETERS OF RESISTANT DIABETIC MACULAR EDEMA AFTER SURGICAL TREATMENT

Anti-angiogenic injections are currently established as the «gold standard» for treating diabetic macular edema (DME). Vitreoretinal surgery is indicated in cases involving an epiretinal membrane or vitreoretinal traction syndrome. Some physicians consider it feasible to perform vitrectomy with the removal of the internal limiting membrane in patients with this condition.The objective of this study is to assess changes in the morphofunctional parameters of the retina in patients with resistant forms of DME who have undergone surgical intervention. At the N.I. Pirogov National Medical and Surgical Center, 75 patients diagnosed with DME unresponsive to conservative therapy (anti-vascular proliferation therapy, retinal laser coagulation) were operated on. All patients were divided into three groups based on the type of intervention.Evaluation of best-corrected visual acuity after surgery revealed a statistically significant improvement in this parameter among patients in the second and third groups compared to those in the first group six months post-operation. Patients in the third group showed a notable reduction in retinal thickness in the foveal area one month after the intervention. A significant decrease in edema was observed in patients from the second and third groups compared to those in the first group over the period from one month to one year. When assessing light sensitivity, a significant improvement in parameters was noted in patients from the second and third groups compared to the data from the first group one week after the surgery.The results confirm the high effectiveness of vitreoretinal surgical intervention in patients with resistant diabetic macular edema, affirming the possibility of selecting a surgical approach.

Retinal Thickness Change Following Cataract Surgery in Eyes with Epiretinal Membranes.

Purpose: To investigate intraretinal changes and central millimeter thickness (CMMT) after successful uncomplicated cataract surgery in patients with asymptomatic epiretinal membrane (ERM). Design: prospective, single-center, interventional case series. Methods: Thirty eyes from 26 patients with cataract and ERM (ERM group) and fifteen consecutive eyes with senile cataract with a healthy macula (control group) were included. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) as well as biomicroscopy were performed at baseline, one week, one month and three months after cataract surgery. OCT raster scans were further analyzed regarding CMMT and structural changes in the retinal morphology. Results: The baseline mean visual acuity improved significantly three months after cataract surgery in both groups (p < 0.05). CMMT in the ERM group was 342 (±53 μm) at baseline and increased significantly to 356 (±57) μm after three months (p < 0.05). One patient in the ERM group developed temporary cystoid macular edema one week after cataract surgery that resolved under topical treatment within three months. CMMT in the control group increased significantly three months after cataract surgery as well but no structural changes in the retinal morphology were observed in this group. Conclusions: This study provides evidence that cataract surgery in eyes with asymptomatic pre-existing ERM can be considered as safe and effective, resulting in good visual acuity outcomes. However, an increase in CMMT and temporary mild changes in retinal morphology may occur.

Diagnosing glaucoma progression with optical coherence tomography.

Optical coherence tomography (OCT) is a widely used tool to diagnose and monitor glaucoma by objectively measuring the ganglion cell layer and the retinal nerve fiber layer (RNFL) thickness. The presence of RNFL thinning raises suspicion for glaucoma progression. Therefore, this review aims to discuss current approaches to using OCT for detecting glaucomatous change, limitations, and recent advancements. Previously established approaches to determining glaucomatous progression on OCT include quantitative and qualitative methods. The most common quantitative methods include event-based and trend-based analysis. Decreasing RNFL thickness or loss of the ganglion cell layer are indicative of glaucomatous changes. However, interpretation of OCT scans is strongly impacted by artifacts, which can be because of epiretinal membrane or posterior vitreous detachment. Race and aging also may impact interpretation of RNFL progression. More recent research focuses on loss of the RNFL because of the effects of systemic conditions. Given the limitations in the current approaches, recent advancements indicate a promising role for artificial intelligence in determining true glaucomatous progression. This review highlights current approaches to identifying glaucoma progression on OCT, limitations to these approaches, and the potential role for artificial intelligence.

Clinical and mutational signatures of CRB1-associated retinopathies: a multicentre study

BackgroundTo delineate the clinical and mutational signatures of patients with CRB1-associated retinopathies.MethodsThis multicentre retrospective cohort study involved 40 patients with CRB1 mutations and 40 age-matched and gender-matched inherited retinal diseases...

Pneumatic Retinopexy with Focal Laser Photocoagulation for Myopic Foveoschisis with Macular Detachment.

To describe the clinical course and imaging of a case of myopic foveoschisis (MF) with macular detachment (MD), microbreak and epiretinal membrane (ERM) managed with pneumatic retinopexy (PR) and focal laser photocoagulation (FLP) of the microbreak. Retrospective Case Review of a highly myopic, phakic Caucasian man who developed vision loss due to MF with MD. 66 year old phakic man with a refractive error of -13.25-2.25x150 in his left eye (OS) and one month visual loss who was diagnosed with MF with MD, microbreak and ERM developed recurrent, isolated, posterior, partial macular detachment one month after PR. CMT was 901um. Repeat PR with supplemental FLP surrounding the inferior macular periarteriolar microbreak achieved re-attachment and improvement in the retinoschisis with return of visual acuity from 20/150 to baseline 20/40+ at 18 month follow-up. PR with FLP may provide an alternative to vitrectomy and MP for the repair of MF with MD and ERM.