Optical coherence tomography biomarkers for visual acuity in patients with idiopathic epiretinal membrane

Abstract

Purpose: To investigate the correlation between outer and inner retina optical coherence tomography (OCT) biomarkers and visual acuity in patients with idiopathic epiretinal membrane (iERM) and identify which of them may be predictive of visual function. Methods: A retrospective cross-sectional single-center study was conducted that included patients diagnosed with iERM. Spectral domain OCT images were obtained and assessed qualitatively and quantitatively. The association of OCT parameters with best corrected visual acuity was analyzed. Results: Charts of 97 eyes of 97 patients were reviewed. Central foveal thickness, maximal retinal thickness (MRT), photoreceptor outer segment length, outer foveal thickness, ganglion cell-inner plexiform layer complex thickening, inner retinal thickness and inner retinal layer irregularity index were among the major outcome measures. OCT scans were also assessed for the presence of cotton ball sign, ellipsoid zone disruption, ectopic inner foveal layer, disorganization of retinal inner layers (DRIL), intraretinal fluid, subretinal fluid (SRF) and epimacular membrane rip. Univariate analysis showed statistically significant association between all the aforementioned parameters with worse vision, except for cotton ball sign and SRF. Multivariate analysis found that MRT and severe DRIL were strongly correlated with worse vision ( p < 0.001). Conclusion: MRT and severe DRIL should be considered as negative prognostic factors for visual acuity.

Diagnostische Reliabilität von optischen Kohärenztomografie-Biomarkern für postoperativen Erfolg bei idiopathischen epiretinalen Membranen

“…We have found DRIL and CMT to be significant predictors for final BCVA in a multiple regression analysis. This outcome is comparable with the results of Karasavvidou et al 23 , who found severe DRIL and maximal retinal thickness to be significant predictors. Nevertheless, intra- and interobserver reliability in diagnosing OCT biomarkers for success in visual acuity among patients with iERM are different between biomarkers, indicating potential for disagreement in diagnosis.…”

“…Wir fanden in der multiplen Regressionsanalyse DRIL und CMT als signifikante Prädiktoren für den postoperativen BCVA. Dieses Ergebnis ist vergleichbar mit den Resultaten von Karasavvidou et al [23], die berichteten, dass ausgeprägte DRIL und hohe retinale Dicke signifikante Prädiktoren sind. Unabhängig von diesen Resultaten zeigen die Intra-und Interobserver-Reliabilitätswerte für die Diagnose von OCT-Biomarkern für postoperativen Visuserfolg bei Patientinnen und Patienten mit iERM Unterschiede zwischen den einzelnen Biomarkern und weisen ein Potenzial für deren unterschiedliche Bewertung in der Diagnose auf.…”

“…Biomarker der optischen Kohärenztomografie (OCT-Biomarker) für postoperativen Visuserfolg bei Patientinnen und Patienten mit iERM, die als Faktoren mit Einfluss auf die postoperativen Resultate in Einzelfaktoranalysen beschrieben wurden, sind: Veränderungen der ellipsoiden Zone 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , das „cotton ball sign“ 20 , epimakuläre Risse der iERM (EMM-Rip) 21 , retinale Kontraktion 8 , „ectopic inner foveal layer“ (EIFL) 19 , „disorganization of inner retinal layers“ (DRIL) 22 , die Makuladicke 8 und intraretinale zystoide Veränderungen 10 , 11 . Karasavvidou et al fanden in ihrer multifaktoriellen Analyse, dass die Makuladicke und DRIL mit schlechteren postoperativen Ergebnissen assoziiert sind 23 . Eine Limitation der Studie ist die Tatsache, dass Karasavvidou et al das Grading der OCTs durch eine/n „single masked investigator“ durchgeführt haben und daher keine Berechnung der Reliabilität der Diagnose von OCT-Biomarkern möglich war.…”

Prediction of Visual Impairment in Epiretinal Membrane and Feature Analysis: A Deep Learning Approach Using Optical Coherence Tomography

“…However, previous studies regarding the correlation between visual acuity and retinal structural changes on OCT have reported conflicting results. Some studies have suggested that outer retinal change is a determinant of visual function,8–10 while others have addressed the role of inner retinal changes 11–16. Meanwhile, some OCT-based ERM classifications have been proposed to correlate with visual function,1,11,17,18 but none have been widely accepted in clinical practice.…”

“…Some studies have suggested that outer retinal change is a determinant of visual function, [8][9][10] while others have addressed the role of inner retinal changes. [11][12][13][14][15][16] Meanwhile, some OCT-based ERM classifications have been proposed to correlate with visual function, 1,11,17,18 but none have been widely accepted in clinical practice. In other words, the OCT biomarkers for visual impairment in patients with ERM are yet to be determined.…”