Arcuate Nerve Fiber Layer Changes After Internal Limiting Membrane Peeling in Idiopathic Epiretinal Membrane

Scupola, Andrea; Grimaldi, Gabriela; Abed, Edoardo; Sammarco, Maria Grazia; Giudiceandrea, Andrea; Greco, Andrea; Sasso, Paola; Blasi, Maria Antonietta

doi:10.1097/iae.0000000000001768

Cited by 23 publications

(21 citation statements)

References 20 publications

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“…On the other hand, alterations of the optical fibers may occur during surgery when thick and strongly adherent membranes are removed from the retina or in connection with inappropriate contact with surgical instruments. These intraoperative traumas may result in the disappearance of optical fibers called SANFL (for swelling of the arcuate retinal nerve fiber layer, 20 often visible a few weeks after surgery. They appear as an arciform defect in the optical fibers layer, which is clearly visible on blue light image or color photograph, or better in false colors (“Multicolor” by Spectralis ® Heidelberg Engineering, Dossenheim, Germany).…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of retinal sensitivity assessed by microperimetry in patients with internal limiting membrane peeling

Blautain

Glacet–Bernard

Blanco-Garavito

et al. 2021

European Journal of Ophthalmology

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Purpose: To evaluate anatomical and functional changes in patients with vitreomacular interface disease after internal limiting membrane (ILM) peeling, using microperimetry along with usual clinical and multimodal retinal imaging. Methods: Patients with vitreomacular interface disease requiring vitrectomy underwent multimodal retinal evaluation, including visual acuity assessment, fundus color photograph, Spectral-Domain Optical Coherence Tomography, Optical Coherence Tomography-Angiography, and microperimetry. They were examined at baseline (M0), 6 months (M6) and 18 months (M18) after surgery. Retinal sensitivity was subdivided into three concentric polygons: Large, Medium, Small. Results: Eleven eyes of 11 patients were analyzed, including 10 epiretinal membranes (ERMs). Best-corrected visual acuity (BCVA) improved in all patients from 0.51 logarithm of the minimal angle of resolution (logMAR) to 0.067 ( p = 0.0074). Retinal sensitivity improved between M0 and M6 in all polygons and continued to improve between M6 and M18 for polygons Medium (M) and Small (S) with no statistical significance. At M18, BCVA and retinal sensitivity were similar in the operated eye compared with the fellow eye for all patients. Dissociated optic nerve fiber layer appearance was observed in 8 patients at M18. It was not correlated with either retinal sensitivity or BCVA or microscotomas. No recurrence of ERM or macular hole occurred during follow-up. Conclusion: After surgery, the retinal sensitivity assessed by microperimetry gradually improved until the 18th month and was not different from the values of the fellow eye. These results seemed to confirm that ILM peeling can be an effective and safe technique to treat patients with vitreomacular interface disease.

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Section: Discussionmentioning

confidence: 99%

Long-term follow-up of retinal sensitivity assessed by microperimetry in patients with internal limiting membrane peeling

Blautain

Glacet–Bernard

Blanco-Garavito

et al. 2021

European Journal of Ophthalmology

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“…ey reported significant RNFL thickness decreases in temporal inferior and nasal inferior sectors in the group with surgically induced PVD, but no change except temporal sector thinning in the group with preexisting PVD [16]. Scupola et al analyzed the relationship between swelling of the arcuate nerve fiber layer and longterm decrease of RNFL thickness after internal limiting membrane peeling for idiopathic ERM and reported decrease in the temporal sectors, and the linear extent of swelling was significantly correlated with the percentage of reduction in RNFL in the temporal and inferotemporal sectors at 12 months of follow-up [17]. Ohta et al investigated circumpapillary RNFL thickness following macular hole (MH) surgery with ILM peeling combined with phacoemulsification and reported significant increase in the superior-temporal and superior-nasal sectors that remained until the 12 th month [18].…”

Section: Discussionmentioning

confidence: 99%

The Effect of the Idiopathic Epiretinal Membrane and Surgically Induced Posterior Vitreous Detachment on the Retinal Nerve Fiber Layer

Altun

2020

Journal of Ophthalmology

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Aim. To investigate the changes in the retinal nerve fiber layer (RNFL) following pars plana vitrectomy (PPV) with surgically induced posterior vitreous detachment (PVD) and idiopathic epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling. Methods. Patients with unilateral ERM with vitreomacular traction were included in this prospective, randomized, and controlled clinical trial. The control group (Group 1) was formed with the nonoperated fellow eyes of the patients, and the study group (Group 2) was formed with the eyes that underwent PPV including idiopathic ERM and ILM peeling. In the preoperative and postoperative periods (1st, 2nd, 3rd, 6th, and 12th months), complete ophthalmological examination of the eyes was performed and RNFL measurements were examined in 4 different quadrants (superior, temporal, inferior, and nasal) with the help of spectral domain optical coherence tomography (OCT). Results. There was no statistically significant change in Group 1 during the follow-up period in all quadrants ( p > 0.05 ). The mean RNFL thickness in Group 2 was statistically significantly higher than in Group 1 in superior, inferior, and temporal quadrants ( p < 0.01 ), preoperatively. The mean RNFL in Group 2 was higher in the 1st, 2nd, 3rd, and 6th months and lower in the 12th month in superior, inferior, and temporal quadrants ( p < 0.01 ) when compared to the preoperative period. The mean RNFL thickness in the nasal quadrant in Group 2 was higher in the 1st, 2nd, and 3rd ( p < 0.01 ) months, same in the 6th month ( p > 0.05 ), and lower in the 12th ( p < 0.01 ) month when compared to the preoperative period. Conclusion. Idiopathic ERM may cause an increase in RNFL thickness in superior, inferior, and temporal quadrants with possible tractional effect. PPV with PVD induction and ERM and ILM peeling may cause these RNFL changes.

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“…Another eye developed a central visual field defect. The development of visual field defects has been reported after uneventful vitrectomy and may be due to difficulties in optic nerve head flow during surgery because of increased intraocular pressure levels [17], or else to nerve fiber layer defects produced by intrasurgical manipulation [18]. In fact, two test points within 10° eccentricity in standard automatic perimetry have been shown to have a sensitivity significantly and reproducibly decreased after vitrectomy in glaucomatous eyes [19].…”

Section: Discussionmentioning

confidence: 99%

Epiretinal Membrane Surgery in Daily Clinical Practice: Results of a Proposed Management Scheme

Pareja

Coronado

Contreras

2019

Journal of Ophthalmology

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Purpose To report the results of the epiretinal membrane (ERM) management guidelines followed in our center. Methods Patients with ERM seen between 2014 and 2015, with ≥2 years follow-up or who had undergone ERM surgery, were included. Corrected visual acuity (VA), lens status, and ERM configuration were recorded at each visit. Our guidelines for ERM are if VA is ≥20/30, observation is recommended unless there is moderate/intense metamorphopsia. Vitrectomy is recommended during follow-up if there is a drop >one line in VA with changes in ERM configuration. If VA at diagnosis is <20/30, vitrectomy is recommended. If visual loss is thought to be due to cataract, phacoemulsification is performed first and visual status reevaluated. Results Ninety-nine eyes of 94 patients were included; 52 eyes underwent vitrectomy, and 47 eyes were monitored. From eyes with VA at diagnosis <20/30 (41 eyes), 8 eyes underwent isolated phacoemulsification: VA improved to ≥20/30. Vitrectomy was recommended but refused by 4 patients. The other 29 eyes underwent vitrectomy. Of the 58 eyes with VA at diagnosis ≥20/30, 5 underwent surgery due to metamorphopsia. Eighteen eyes underwent vitrectomy during follow-up. VA improved a mean of 0.13 logMAR (SD 0.30) after vitrectomy. There were no differences in mean VA improvement between eyes that underwent vitrectomy within six months of diagnosis (0.24, SD 0.32) and those that underwent surgery more than six months after diagnosis (mean 0.17, SD 0.17), p=0.106. Three eyes developed postsurgical complications with visual loss: persistent macular edema in one eye, two consecutive retinal detachments in one eye, and a central visual defect in another eye. At the end of follow-up, VA was similar in the observation group (0.14, SD 0.14) and in the vitrectomy group (0.16, SD 0.28), p=0.528. Conclusions Our proposed guidelines lead to visual preservation in most patients while limiting surgery and its possible complications.

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Arcuate Nerve Fiber Layer Changes After Internal Limiting Membrane Peeling in Idiopathic Epiretinal Membrane

Abstract: Early postoperative SANFL is correlated with late focal retinal nerve fiber layer thinning in the temporal sectors. Intraoperative surgical grasping seems to be a leading factor for the onset of SANFL.

Cited by 23 publications

References 20 publications

Long-term follow-up of retinal sensitivity assessed by microperimetry in patients with internal limiting membrane peeling

Long-term follow-up of retinal sensitivity assessed by microperimetry in patients with internal limiting membrane peeling

The Effect of the Idiopathic Epiretinal Membrane and Surgically Induced Posterior Vitreous Detachment on the Retinal Nerve Fiber Layer

Epiretinal Membrane Surgery in Daily Clinical Practice: Results of a Proposed Management Scheme

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