Retinal Adherence and Fibrillary Surface Changes Correlate With Surgical Difficulty of Epiretinal Membrane Removal

Kim, Jae Suk; Chhablani, Jay; Chan, Candy King-Chi; Cheng, Lingyun; Kozák, Igor; Hartmann, Kathrin; Freeman, William R.

doi:10.1016/j.ajo.2011.08.042

Cited by 36 publications

(27 citation statements)

References 13 publications

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“…The broad attachment, in contrast, showed less retinal surface undulating and less visual distortions. These findings are similar to previous reports about idiopathic and uveitic ERM [13,14]. Mori and co-authors also found that around half of the cases with nonidiopathic ERM also showed a focal attachment pattern to the retina [15].…”

Section: Discussionsupporting

confidence: 81%

Prognostic Indicators for Visual Outcomes following Surgery for Epiretinal Membrane Associated with Diabetic Patients

Al-Halafi¹

2017

AOVS

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Purpose: To evaluate the predicting factors for good VA after PPV for ERM associated with DME. Methods:The medical records 29 eyes seen in the Retina Clinic and diagnosed to have ERM associated with DME were reviewed. Investigating potential predicting factors for achieving good vision included a mean change in best-corrected visual acuity (BCVA) before and after PPV, means change in CMT before and after PPV, focal and broad attachment of ERM to the ILM, age, sex and duration of the disease.Results: In the current study, 29 eyes (19 (65.5% OD and 10 (34.5% OS) of 29 patients were recruited. The mean (SD) age of our sample was 60.8 (10.6) years, range . Comparing the mean (SD) LogMAR of preoperative and the last follow-up values, the detected difference was found to be statistically significant (0.5 (0.3), [95% CI: 0.394 -0.608]; p<0.0001). The mean (SD) OCT decreased postoperatively to 352 (128) micron, then to 313 (101.5) micron in the last followup visit assessment, where such decrease from preoperative to the last follow-up assessment was statistically significant (139.2 (92.5) micron, [95% CI: 103.311-175.046]; p<0.0001). Investigating potential predicting factors for achieving vision ≥ 20/60, patients who entered the cohort in a relatively higher age and with a better initial visual acuity were found to be more likely to achieve better postoperative vision (p= 0.016 and 0.004 for age and visual acuity respectively). Conclusion:Pars plana Vitrectomy for ERM peeling associated with DME showed a better visual outcome. Patients with good initial VA achieved a better final visual outcome. Postoperative improvement in vision is slow. OCT appearance cannot predict visual outcome.

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Section: Discussionsupporting

confidence: 81%

Prognostic Indicators for Visual Outcomes following Surgery for Epiretinal Membrane Associated with Diabetic Patients

Al-Halafi¹

2017

AOVS

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“…Также исследовалась выраженность адге-зии ЭРМ и наличие фибриллярного компонента между ЭРМ и слоем нервных волокон по данным ОКТ. При на-личии полного сращения ЭРМ и наличии фибриллярных изменений трудность удаления ЭРМ достоверно увеличи-валась [32].…”

Section: находки на линейных срезах окт макулярной зоны при иэрм (данunclassified

Idiopathic epiretinal membranes: visual function impairment, morphological and functional features of retinal involvement

Ponomareva

Kazaryan

2016

Vestn. oftal'mol.

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“…23 Focal adhesion was defined as ERM-retinal adhesion o50%; broad adhesion between 50 and 90%; and complete adhesion 490% (Figures 1 and 2). In cases where the classification did not agree between the observers for any of the anatomic locations, the type of the ERM adherence to the retina was determined by a third masked observer.…”

Section: Oct Imaging and Epiretinal Membrane-macula Adhesion Classifimentioning

confidence: 99%

“…The ERM-macula adhesion classification was based on the methodology proposed by Kim et al 23 Briefly, a raster of vertical and horizontal SD-OCT images of the ERM structure was obtained over the macula. With the aid of an ETDRS overlay, the posterior pole was divided into five anatomic locations including a foveal (central 1000 microns) and four macular quadrants (superior, inferior, nasal, and temporal) extending up to the large temporal vascular arcades.…”

Section: Oct Imaging and Epiretinal Membrane-macula Adhesion Classifimentioning

confidence: 99%

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The role of membrane-inner retina adherence in predicting simultaneous internal limiting membrane peeling during idiopathic epiretinal membrane surgery

Tranos

Wickham

Dervenis

et al. 2016

Eye

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Purpose To correlate the frequency and extent of simultaneous inadvertent internal limiting membrane (ILM) peeling during idiopathic epiretinal membrane (ERM) removal with characteristics of ERM adherence demonstrated on pre-operative spectral domain optical coherence tomography (SD-OCT). Patients and methods This is a prospective, observational, case series of patients undergoing pars plana vitrectomy for idiopathic ERM. Inner retina-ERM adhesion was categorized as focal, broad or complete in five anatomic locations at macular area based on preoperative SD-OCT findings. The extent of spontaneous ILM peeling was quantified on a scale 0-100% in each of the aforementioned anatomic locations by the operating surgeons who were masked to the OCT characteristics. All operations were recorded with a high definition recording system and the area of simultaneous ILM peel was quantified by a second masked observer. The final extent of spontaneous ILM peel was calculated as the average of the two scores. Results Thirty consecutive subjects who underwent surgery for idiopathic ERM were included in the study. Evidence of simultaneous ILM peeling was identified in 80.3% of individuals. With regards to the type of ERM-macula adhesion, inadvertent ILM peel was observed in 70% of the patients who pre-operatively showed complete adhesion, in 43% with broad adhesion and in only 21% with focal adhesion (Po0.001). The extent of the spontaneous ILM peel during removal of ERM was also significantly dependent on the type of ERM-inner retina adhesion. Total simultaneous ILM peel was observed in 59% of locations with complete ERM-macula adhesion but only in 22% and 7% of locations with broad and focal adhesion respectively (Po0.001). Conclusions Simultaneous ILM peel is a frequent occurrence during ERM surgery, especially when there is complete or broad ERM adherence to the macula. The type of ERM-inner retina adhesion represents a valid predictor of the extent of simultaneous ILM peel during removal of ERM. Thorough evaluation of preoperative OCT may be a useful tool in determining a safer, more simplistic strategy in ERM surgery.

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Retinal Adherence and Fibrillary Surface Changes Correlate With Surgical Difficulty of Epiretinal Membrane Removal

Cited by 36 publications

References 13 publications

Prognostic Indicators for Visual Outcomes following Surgery for Epiretinal Membrane Associated with Diabetic Patients

Prognostic Indicators for Visual Outcomes following Surgery for Epiretinal Membrane Associated with Diabetic Patients

Idiopathic epiretinal membranes: visual function impairment, morphological and functional features of retinal involvement

The role of membrane-inner retina adherence in predicting simultaneous internal limiting membrane peeling during idiopathic epiretinal membrane surgery

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