High-Resolution Multimodal Imaging After Idiopathic Epiretinal Membrane Surgery

Lombardo, Marco; Scarinci, Fabio; Giannini, Daniela; Pileri, Marco; Ripandelli, Guido; Stirpe, Mario; Lombardo, Giuseppe; Serrao, Sebastiano

doi:10.1097/iae.0000000000000679

Cited by 10 publications

(2 citation statements)

References 32 publications

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“…Adaptive optics scanning laser ophthalmoscopy has been used by researchers to examine the retina in patients with ERM. Macrofolds, microfolds (5‐10 μm) and hyper‐reflective microstructures of the vitreomacular interface have been seen to resolve or redistribute after surgical ERM peeling 124 . These hyper‐reflective microstructures have been observed in other retinal and even neurological conditions, raising the possibility that they represent reactive gliosis in the inner retinal layers 125‐129 …”

Section: Investigationsmentioning

confidence: 99%

Epiretinal membrane: A review

Fung

Galvin

Tran

2021

Clinical Exper Ophthalmology

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The prevalence of epiretinal membrane (ERM) is 7% to 11.8%, with increasing age being the most important risk factor. Although most ERM is idiopathic, common secondary causes include cataract surgery, retinal vascular disease, uveitis and retinal tears. The myofibroblastic pre‐retinal cells are thought to transdifferentiate from glial and retinal pigment epithelial cells that reach the retinal surface via defects in the internal limiting membrane (ILM) or from the vitreous cavity. Grading schemes have evolved from clinical signs to ocular coherence tomography (OCT) based classification with associated features such as the cotton ball sign. Features predictive of better prognosis include absence of ectopic inner foveal layers, cystoid macular oedema, acquired vitelliform lesions and ellipsoid and cone outer segment termination defects. OCT‐angiography shows reduced size of the foveal avascular zone. Vitrectomy with membrane peeling remains the mainstay of treatment for symptomatic ERMs. Additional ILM peeling reduces recurrence but is associated with anatomical changes including inner retinal dimpling.

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Section: Investigationsmentioning

confidence: 99%

Epiretinal membrane: A review

Fung

Galvin

Tran

2021

Clinical Exper Ophthalmology

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“… 8 Other studies have reported the persistence of subfoveal tractional abnormalities despite surgical removal of tractional membranes. 11 The purpose of the current study is to report the clinical and anatomic outcomes of eyes with tractional abnormalities of the central foveal bouquet (CB) due to idiopathic epiretinal membranes (iERMs).…”

Section: Introductionmentioning

confidence: 99%

<p>The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes</p>

Damasceno¹,

Damasceno²,

Yannuzzi³

et al. 2020

OPTH

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Purpose To report both the unoperated clinical course and the surgical outcomes of eyes with a central foveal bouquet (CB) secondary to idiopathic epiretinal membranes (iERMs). Design Retrospective, consecutive, and observational case series. Methods All patients examined between January 1, 2014, and December 31, 2019, for evaluation of epiretinal membrane with a CB lesion identified on spectral domain optical coherence tomography (SD-OCT) were included. Exclusion criteria included vitreoretinal comorbidities associated with secondary ERMs and an absence of CB lesions on SD-OCT. Patients were divided into two groups: those who were followed with observation (Group I) and those who received surgery (Group II). Each group had 3 different types of mechanical abnormalities of the CB previously described as cotton ball sign, subfoveal detachment, or acquired vitelliform lesion, without a subanalysis discrimination. Main Outcome Measures Best-corrected visual acuity (BCVA) at baseline and last follow-up, subjective metamorphopsia, central retinal thickness (CMT), mechanical stress lesions of the CB, and resolution or evolution of the CB lesions during the follow-up interval. Results Two hundred seventy-six eyes with iERM were reviewed, and 46 eyes met the inclusion criteria. Among these, 21 of 46 (46%) were observed, and 25 of 46 (54%) underwent surgery. Metamorphopsia was identified in 61.9% of patients in Group I and 81.2% of patients in Group II, at baseline. The mean BCVA was 0.19 ± 0.17 (20/30) in Group I and 0.31 ± 0.33 (20/40) in Group II at presentation. At the final exam, patients in Group I achieved a mean BCVA of 0.24 ± 0.18 (20/30), while patients in Group II obtained a mean BCVA of 0.15 ± 0.21 (20/30). Spontaneous resolution of the CB sign occurred in 5 of 21 eyes (23.8%) that were observed, whereas, after surgery, the CB sign resolved in 16 of 25 eyes (61.5%). Mean CMT was 422 ± 84.2μm in Group I and 531 ± 143.9μm in Group II, at baseline, while at the latest follow-up, the mean CMT was 400 ± 40.8μm in the cases followed with observation and 454 ± 148.7μm in the surgical cases. Conclusion The clinical course and surgical outcomes of CB findings in iERM are favorable in terms of visual acuity. However, those receiving surgery had an increase in visual acuity and resolution of the CB abnormality.

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