Short-term postoperative changes in the choroidal vascularity index in patients with a unilateral epiretinal membrane

Abstract

Background To investigate short-term choroidal structural and vascular changes after epiretinal membrane (ERM) surgery. Methods In this retrospective study, 65 patients with unilateral ERM underwent pars plana vitrectomy combined with cataract surgery and were examined one day before surgery and one week, one month, and three months after surgery. Choroidal thickness (CT) and choroidal vascular index (CVI) were evaluated using horizontal enhanced depth imaging optical coherence tomography (EDI-OCT) scans and were further calculated using semi-automatic algorithms using MATLAB R2017a. Results Preoperatively, CVI was higher in eyes with ERM (61.70 ± 5.17%) than in fellow eyes (59.99 ± 5.26%). CVI increased significantly at one week after surgery (62.14 ± 5.02%) and decreased at 1 and 3 months after surgery (60.76 ± 4.97% and 60.4 ± 4.83%, respectively). The change was pronounced in the nasal region (p < 0.001) and central region (p < 0.05). CT in the temporal macula increased at 1 week (239.65 ± 72.98 μm) after surgery and decreased at 1 and 3 months after surgery (222.15 ± 71.91 μm and 222.33 ± 65.72 μm, respectively; p < 0.01). Conclusions Short-term postoperative variations in the choroid have been demonstrated in eyes with ERM. This may be related to the release of macular traction. CVI assessment using EDI-OCT may be a useful tool for investigating choroidal structural changes accompanying ERM and postoperative period.

Choroidal Complications of Vitreoretinal Surgery

“…19 Epiretinal membran olgularında PPV sonrasında erken dönemde koroid vaskularite indeksinin merkezde artmış olduğu gösterilmiş ve bu durumdan sorumlu mekanizmalardan birisinin de cerrahinin yarattığı travmanın kan-aköz bariyerini bozması sonucunda hümör aközde bulunan inflamatuar mediatörlerin koroide geçerek bazı yapısal değişiklikleri tetiklemesi olduğuna dair yorum yapılmıştır. 20 Odrobina ve ark., proliferatif vitreoretinopatili regmatojen retina dekolmanı olgularında PPV ve silikon yağı endotamponadı sonrasında koroid kalınlığında ilerleyici bir azalma meydana geldiği göstermişler ve bu durumu silikon yağının koroid iskemisine yol açma potansiyeli ile ilişkilendirmişlerdir. Yazarlar, retinektomi uygulanan olgularda koroid kalınlığındaki azalmanın daha da belirgin olmasının hipotezlerini doğrular nitelikte olduğu yorumunu da eklemişlerdir.…”