Ectopic inner foveal layer as a factor associated with metamorphopsia after vitrectomy for epiretinal membrane

Abstract

Purpose To analyse the relationship between the extent of metamorphopsia and optical coherence tomography (OCT) parameters including the ectopic inner foveal layer (EIFL) in patients with epiretinal membrane (ERM) who underwent pars plana vitrectomy (PPV). Methods This study included 63 eyes of 62 patients who underwent PPV for ERM. Metamorphopsia was assessed by measuring the metamorphopsia score for vertical lines (MV) and metamorphopsia score for horizontal lines (MH) using M‐CHARTS. Central retinal thickness (CRT), EIFL thickness and disruption of outer retinal layers were measured before and after surgery, and the relationship of these parameters with metamorphopsia scores at 3 months after vitrectomy was analysed. Results Preoperative MV correlated with preoperative CRT and EIFL (p = 0.005 and 0.045 respectively). Postoperative MH correlated with preoperative CRT (p = 0.048), while postoperative MV correlated with preoperative CRT and EIFL (p = 0.002 and 0.0006 respectively). Postoperative MH correlated with postoperative CRT and EIFL (p = 0.001 and 0.002 respectively), and postoperative MV also correlated with postoperative CRT and EIFL (p = 0.0008 and < 0.0001 respectively). MH and MV did not correlate with outer retinal layer disruptions, both before and after vitrectomy. When multiple regression analysis was performed on preoperative and postoperative OCT parameters that correlated with postoperative metamorphopsia scores, only postoperative EIFL was identified as an independent factor associated with postoperative MV (p = 0.042). Conclusion When PPV was conducted for ERM, postoperative EIFL was found to be a significant factor associated with postoperative metamorphopsia score.

The effect of ectopic inner foveal layer thickness on metamorphopsia in idiopathic epiretinal membranes

“…Furthermore, Yanagida et al reported that there was a significant relationship between EIFL thickness and metamorphopsia scores both preoperatively and postoperatively. [14] In this study, we observed that postoperative EIFL thickness decreased significantly, BCVA (LogMAR), MH, and MV decreased significantly compared to the preoperative period. However, we found no correlation between BCVA, MH, MV, and EIFL thickness neither in the preoperative nor in the postoperative period.…”

“…[13] Yanagida et al reported that there was a significant relationship between EIFL thickness and metamorphopsia scores both preoperatively and postoperatively. [14] To the best of our knowledge, both stage 3 and stage 4 ERMs have been included in studies on this subject, including the studies mentioned above. The retinal structure is disrupted in stage 4 ERMs.…”