Spectral-Domain Optical Coherence Tomography for Monitoring Epiretinal Membrane Surgery

Falkner-Radler, Christiane I.; Glittenberg, Carl; Hagen, Stefan; Benesch, Thomas; Binder, Susanne

doi:10.1016/j.ophtha.2009.08.034

Cited by 188 publications

(178 citation statements)

References 25 publications

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“…In the present study, the breakdown of IS/OS junction line of the photoreceptors layer was found in 3 eyes preoperatively which showed no improvement in visual outcome after PPV for ERM removal. Previous studies showed the same results [14,17].…”

Section: Discussionsupporting

confidence: 72%

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: 72%

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

Al-Halafi¹

2017

AOVS

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“…Notably, the baseline CRT and appearance of the foveal contour did not significantly influence distance and near visual acuity outcomes at 3-month follow-up. However, patients with a continuous or interrupted IS/OS line exhibited significant improvements in distance and near visual acuity at 3 months, as well as a significantly higher rate of improvements in both distance and near visual acuity, compared to patients with a nearly absent IS/OS line (7) . Suh et al (8) evaluated 101 eyes of 101 patients with idiopathic ERM who underwent PPV for ERM removal.…”

Section: Discussionmentioning

confidence: 85%

“…This characteristic is important because longstanding morphological changes in the retina can lead to irreversible functional damage. Extensive studies of the integrity of the photoreceptor IS/OS line have demonstrated a significant association between an intact IS/OS line and better postoperative BCVA after successful removal of an ERM (6,7,10,14) . Inoue et al (6) evaluated the prognostic value of IS/OS line integrity and observed significantly better postoperative BCVA in patients with an intact IS/OS junction pre-operation.…”

Section: Discussionmentioning

confidence: 99%

“…Disruption of this layer reflects an anatomical disruption of the retinal photoreceptors (4,5) . Studies involving SD-OCT in patients with ERM have shown that visual acuity deteriorates as a result of IS/OS junction disruption (6)(7)(8)(9)(10) , and that there is thickening of the central macula (8)(9)(10)(11)(12) and outer retina (11,12) . In support of this, Oster et al (13) found that the IS/OS junction was a more useful predictor of poor visual acuity when compared with central macular thickness.…”

Section: Introductionmentioning

confidence: 99%

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

Aydin¹,

Karahan²,

Kaya³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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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

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“…In addition, it helps us to define the integrity and the changes of the inner and outer retinal layers at each follow up visit [4]. The treatment of choice for ERM is pars plana vitrectomy (PPV) and ERM peeling.…”

Section: Introductionmentioning

confidence: 99%

Long Term Outcomes after Pars Plana Vitrectomy for the Treatment of Epiretinal Membranes

Mela¹

2016

AOVS

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Purpose: To report the long-term outcomes of surgical treatment of epiretinal membranes (ERM) with pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling.Methods: This was a retrospective interventional case series of patients with symptomatic ERM. 340 eyes of 322 patients were included in the study. Mean age of the sample was 68±12 years. Preoperative and postoperative Corrected Distance Visual Acuity (CDVA), as well as Intraocular Pressure (IOP) measurements were compared, Central Macular Thickness (CMT) from Optical Coherence Tomography (OCT) was correlated with CDVA at all time intervals. Results:No intraoperative or immediate postoperative complications were observed. Mean preoperative CDVA was 0.6±0.3 logMAR. Statistically significant improvement was noted at all postoperative follow ups (P<0.002). Mean postoperative CDVA at last follow up visit was 0.2±0.2 logMAR. The rate of CDVA's improvement was 67%. IOP measurements showed a statistically significant increase at the 1st postoperative month and then approached the preoperative values, without statistical significance. Mean CMT measurements showed gradual reduction at all follow up visits, from 427±91μm to 268±40μm at the last visit (P<0.0001). The preoperative CMT was statistically significant correlated with pre-and postoperative CDVA at the 6th month, 1 year and last follow up visit (p<0.05). Statistically significant correlations were also found between 1 month postoperative CMT and 1 year postoperative CDVA (P<0.02). CDVA at the last examination was significant correlated with postoperative CMT at 1 month, 6 months (P<0.0001). After multivariate linear regression, postoperative CMT at 1st month, 6th months and 1 year was correlated with CDVA at the last follow up examination. Conclusion:PPV with ILM peel is a justifiable intervention for patients with ERMs, which may offer CDVA improvement and continuous regularization of foveal anatomy through the next years.

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Spectral-Domain Optical Coherence Tomography for Monitoring Epiretinal Membrane Surgery

Cited by 188 publications

References 25 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

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

Long Term Outcomes after Pars Plana Vitrectomy for the Treatment of Epiretinal Membranes

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