Association of macular choroidal thickness with optical coherent tomography morphology in patients with idiopathic epiretinal membrane

Min

Journal of Ophthalmology

et al. 2021

Purpose. To analyze clinical parameters of two subtypes of lamellar macular hole (LMH): degenerative and tractional. Methods. This retrospective chart review study included patients monitored for more than 6 months after the initial diagnosis of LMH from January 2011 to January 2018. LMH was classified in two subtypes: degenerative and tractional. The following parameters between both subtypes were assessed: central subfield thickness (CST), maximum inner diameter (MID), maximum outer diameter (MOD), MID/MOD ratio, inner and outer segment (IS/OS) junction disruption, residual retinal thickness (RRT), subfoveal choroidal thickness (SFCT), best-corrected visual acuity (BCVA), anatomical progression rate, and percentage of patients undergoing surgery. Results. This study included 51 eyes with a mean follow-up period of 18.94 months: 33 eyes with tractional LMH and 18 eyes with degenerative LMH. MID was not significantly different between both subtypes but MOD was significantly greater in tractional LMH than degenerative types (tractional, 1131.6 μm; degenerative, 708.9 μm; p < 0.001). The MID were significantly increased in degenerative eyes, while the tractional eyes featured a significant increase in MOD. BCVA was not significantly different between both subtypes at baseline and the last follow-up. Epiretinal membrane presence was significantly different between the two subtypes (tractional, 96.9%; degenerative, 22.2%; p < 0.001). Ellipsoid defect and rate of receiving surgery were not significantly different between both subtypes. The anatomical progression rate in tractional eyes (81.8%) was significantly higher than that of degenerative LMH (27.7%) ( p = 0.010). The SFCT was correlated to anatomical progression in the tractional LMH (correlation coefficient = 0.351, p = 0.049) but not in the degenerative LMH. During the follow-up period, 4 eyes (22.2%) of the degenerative LMH and 11 eyes (33.3%) of the tractional LMH underwent surgery. Conclusions. We found that greater SFCT at baseline was correlated to anatomical progression of tractional LMH. Therefore, it is expected that SFCT could be used as a biomarker to predict anatomical progression in tractional LMH.

Section: Discussionmentioning

confidence: 92%

Clinical Characteristics of Lamellar Macular Hole Subtypes: Degenerative and Tractional

Min

Journal of Ophthalmology

et al. 2021

“…Another prospective study of 53 eyes reported that choroidal thickness decreased significantly in the subfoveal region and in the nasal and temporal quadrants 3 months after surgery [ 8 ]. In the case of ERM with vitreomacular traction [ 9 ] and ERM with membrane contraction [ 10 ], choroidal thickness was significantly reduced 6 months after surgery compared with that before surgery. Meanwhile, in a retrospective study [ 11 ] that observed 95 eyes up to 1 year after surgery, choroidal thickness was significantly increased 1 week after vitrectomy compared to that of the baseline value, but there was no difference between the thickness 1 month and 12 months after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The difference between these studies is thought to be due to the difference in the degree of ERM before surgery, surgical method, and postoperative follow-up period. A previous study reported a temporary increase in choroidal thickness after surgery [ 11 ], but all studies reported that choroidal thickness decreased over time after surgery or there was no difference from that before surgery [ 7 , 8 , 9 , 10 , 11 , 12 ]. The present study also showed a temporary increase in choroid thickness 1 month after surgery and a decrease at 6 and 12 months after surgery compared with preoperative values.…”

Section: Discussionmentioning

confidence: 99%

“…The authors stated that ERM was not related to choroidal thickness and vice versa [ 8 ]. A recent study found no difference in choroidal thickness between the eyes of patients with ERM without membrane contraction, but the macular choroidal thickness in patients with ERM with membrane contraction was significantly higher than that of their fellow eyes [ 10 ]. Macular traction caused by ERM would increase the dilatation and tortuosity of retinal blood vessels, causing abnormalities in the supply of oxygen and nutrients to the retina.…”

Section: Discussionmentioning

confidence: 99%

“…However, information remains limited about long-term changes in choroidal thickness after vitrectomy. Some studies have shown that the choroid thickness decreases after surgery [ 7 , 8 , 9 , 10 ], whereas other studies have shown there is no change until 12 months after surgery [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Longitudinal Change of Choroidal Thickness after Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane

Bae

Hwang

2022

JCM

This study aimed to investigate changes in choroidal thickness after pars plana vitrectomy (PPV) with and without air tamponade in patients with idiopathic epiretinal membrane (ERM). We retrospectively reviewed 61 patients with ERM who underwent a 25-gauge transconjunctival sutureless PPV. The patients were divided into two groups: the air tamponade group (30 eyes) and the nontamponade group (31 eyes). Subfoveal choroidal thickness (SFCT) was analyzed over 12 months. No significant differences were seen between the two groups at baseline. For all patients, the SFCT was significantly thicker at 1 month after surgery and significantly thinner at 6 and 12 months after surgery than preoperative values. In the subgroup analysis, there was no significant difference in SFCT 3 months after surgery compared with the preoperative values in both groups, but SFCT was significantly lower 6 months after surgery in both groups. In conclusion, our results showed that choroidal thickness temporarily increased after surgery and then gradually decreased until 12 months after the PPV for ERM.

Asia-Pacific Journal of Ophthalmology

Prediction of Visual Impairment in Epiretinal Membrane and Feature Analysis: A Deep Learning Approach Using Optical Coherence Tomography

Hsia

Lin

Wang

et al. 2023

Purpose: The aim was to develop a deep learning model for predicting the extent of visual impairment in epiretinal membrane (ERM) using optical coherence tomography (OCT) images, and to analyze the associated features. Methods: Six hundred macular OCT images from eyes with ERM and no visually significant media opacity or other retinal diseases were obtained. Those with best-corrected visual acuity ≤ 20/50 were classified as "profound visual impairment," while those with bestcorrected visual acuity > 20/50 were classified as "less visual impairment." Ninety percent of images were used as the training data set and 10% were used for testing. Two convolutional neural network models (ResNet-50 and ResNet-18) were adopted for training. The t-distributed stochastic neighbor-embedding approach was used to compare their performances. The Grad-CAM technique was used in the heat map generative phase for feature analysis.Results: During the model development, the training accuracy was 100% in both convolutional neural network models, while the testing accuracy was 70% and 80% for ResNet-18 and ResNet-50, respectively. The t-distributed stochastic neighbor-embedding approach found that the deeper structure (ResNet-50) had better discrimination on OCT characteristics for visual impairment than the shallower structure (ResNet-18). The heat maps indicated that the key features for visual impairment were located mostly in the inner retinal layers of the fovea and parafoveal regions.Conclusions: Deep learning algorithms could assess the extent of visual impairment from OCT images in patients with ERM. Changes in inner retinal layers were found to have a greater impact on visual acuity than the outer retinal changes.