Evaluation of inner segment/outer segment junctions in different types of epiretinal membranes

Abstract

Purpose: This study was conducted to evaluate the relationships of inner/outer segment (IS/OS) junction disruption, macular thickness, and epiretinal membrane (ERM) grade with best-corrected visual acuity (BCVA), as well as the relationship between IS/OS junction disruption and ERM grade. Methods: Fifty-four eyes of 54 patients with different grades of ERM were retrospectively reviewed. Patients were classified into three groups by ERM grade according to retinal striae and vessel distortion: grade/group 1, visible membranes without retinal striae or vessel distortion; grade/group 2, mild to moderate macular striae or vessel straightening; and grade/group 3, moderate to severe striae and vascular straightening. Correlations of BCVA with age, central retinal thickness, ERM grade, and IS/OS disruption as well as of IS/OS disruption, central macular thickness, and BCVA with ERM grade were evaluated. Results: Twenty-nine (53.7%) eyes exhibited IS/OS junction disruption. Groups 1 and 2 differed significantly with respect to BCVA (p=0.038), but groups 2 and 3 did not (p=0.070). Central macular thickness was significantly greater in group 2 than in group 1 (p=0.031) and in group 3 than in group 2 (p=0.033). Groups 1 and 2 differed significantly in terms of IS/OS disruption (p=0.000), but groups 2 and 3 did not (p=0.310). Conclusions:The IS/OS junction appears to be disrupted during the early stages of ERM. Grade 3 ERM is associated with a significantly higher incidence of IS/OS disruption. Keywords

Correlation between Uncorrected Visual Acuity and Macular Distortion in Idiopathic Epiretinal Membrane Patients

“…Among morphological changes of the retina in idiopathic ERM patients observed in OCT, outer retinal integrity seems to be related to potential visual acuity. This is consistent with previous studies showing that ellipsoid zone or interdigitation zone is related to BCVA [ 7 8 9 10 11 12 ]. UCVA was not associated with outer retinal integrity, but was significantly correlated with CMT and inner retinal irregularity index.…”

“…In contrast, patients with retinal abnormalities typically showed more decreased UCVA even with mild refractive error. In most clinical studies, visual function has been measured by BCVA after correcting refractive errors, and BCVA showed good correlation with retinal status [ 7 8 9 10 11 12 ]. Few studies have focused on UCVA, and there is little study on the relationship between UCVA and retinal state.…”

The outcomes of epiretinal membrane peeling in patients with foveal herniation

“…Several types of epiretinal membranes were defined in previous studies [ 3 , 4 , 7 – 9 , 12 , 13 ]. Hwang et al [ 8 ] were the first authors to define the later so called "foveal herniation" subtype as "outer retinal inward projection and inner retinal thickening.…”

“…Surgical treatment is usually required if it causes metamorphopsia and visual deterioration, and consists of vitrectomy and ERM peeling [ 4 – 6 ]. After the introduction of optical coherence tomography (OCT), different ERM subtypes have been described [ 7 – 9 ]. The ERMs have been classified into diffuse, cystoid macular edema, vitreomacular traction, and pseudolamellar hole subtypes [ 7 ].…”