To determine the degree of misalignment between the center of foveal avascular zone and the center of foveal photoreceptors in eyes with an idiopathic epiretinal membrane (ERM).Methods: We reviewed the medical records of 61 eyes with an idiopathic ERM. A 3 • 3 mm area centered on the fovea was scanned with optical coherence tomography angiography before and at 6 months after surgery. The center of foveal avascular zone and the center of foveal photoreceptors were detected by en-face optical coherence tomography angiography images and sequential optical coherence tomography B-sections in the macular region. The presence or absence of ectopic inner foveal layers was also evaluated.Results: The mean distance from the center of foveal photoreceptors to the center of foveal avascular zone was 111.7 ± 106.8 mm in eyes with preoperative ERM. This distance was significantly correlated with the preoperative central foveal thickness (r = 0.33, P = 0.0104). Preoperatively, the ectopic inner foveal layers were present in 27 (44.3%) of 61 eyes. The foveal misalignment was greater in eyes with ectopic inner foveal layers than in those without ectopic inner foveal layers (158.6 ± 140.0 vs. 74.4 ± 45.4 mm, P , 0.0003). At 6 months after ERM surgery, the foveal misalignment was significantly reduced to 73.7 ± 48.0 mm (P = 0.0018).Conclusion: Determining the degree of misalignment between the center of foveal avascular zone and the center of foveal photoreceptors might be a useful way to evaluate the degree of ERM traction.
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