Clinical characteristics of patients with epiretinal membrane-Foveoschisis

Abstract

Purpose The purpose of this study is to investigate the clinical and morphological characteristics of epiretinal membrane (ERM)-Foveoschisis. Methods Medical charts of 2088 patients diagnosed with idiopathic ERM were screened and eyes with ERM-Foveoschisis were included. All eyes underwent a complete ophthalmological examination including spectral domain optical coherence tomography (SD-OCT). OCT features and best corrected visual acuity (BCVA) were analysed. ERM-Foveoschisis was defined as open, closed, elevated or flat based on the OCT features. Ellipsoidal zone (EZ) abnormality, intraretinal cystoid spaces, central foveal thickness (CFT), posterior vitreous detachment (PVD) and lens status were assessed. Results One hundred-sixty-six patients (175 eyes) (72% female, mean age 70.46 years) were included. Incidence of ERM-Foveoschisis was 6.7%. Open type was seen in 86.8% and had a significantly better mean BCVA than closed type (p = 0.01). No statistically significant difference of mean BCVA was noted between the elevated and flat types. Mean BCVA was significantly lower in eyes with EZ abnormality (p = 0.03) and eyes with intraretinal cystoid spaces (p = 0.02). Patients with ‘closed’ ERM-Foveoschisis showed a significant higher median CFT than ‘open’ ERM-Foveoschisis (respectively, 364 µm and 176 µm, p < 0.001). A total of 81.9% eyes had PVD. Conclusion We differentiated four morphological types of ERM-Foveoschisis based on the OCT examination. Closed ERM-Foveoschisis presented with a higher CFT and lower BCVA than the open type. ERM-Foveoschisis with cystoid intraretinal spaces presented with a lower BCVA. The impact of the morphological types of the ERM-Foveoschisis on the clinical course and for therapy decision requires further long-term studies.

Foveal Microstructure and Visual Outcomes after Pars Plana Vitrectomy in Patients with Different Types of Epiretinal Membrane Foveoschisis

“…In our study, we found that the patients in group A whose retinal schisis crossing the central fovea might have a better baseline BCVA, a thicker central foveal point thickness, a more complete EZ layer, and better surgical outcomes than those with FS not crossing the foveal center. However, Hetzel et al [13] divided the eyes with ERM-FS into the "closed" and "open" groups according to their OCT images that were similar to our classification, and found that eyes in the "closed" group had a significantly worse BCVA than that in the "open" group. The major reason for the discrepancy may be due to the different severity of disease conditions between the two studies.…”

“…The major reason for the discrepancy may be due to the different severity of disease conditions between the two studies. In the cases reported by Hetzel et al [13], not all needed surgical treatment, and the mean initial BCVA was better than that in our study. Because there are few researches on ERM-FS at present, the exact reason for this difference is not clear.…”

“…This study has some limitations because of its retrospective design and relatively small sample size. Previous studies indicated an incidence rate of 3.1-6.7% for ERM-FS in iERM patients [12,13]. Moreover, we only included the patients who underwent ERM surgery, so the sample size is relatively small.…”

“…Some studies have already compared the clinical characteristics and surgical outcomes among these three entities [8‒11]. However, few studies have investigated the clinical characteristics of patients with ERM-FS as yet, especially the surgical prognosis [12‒14]. In clinical practice, we have found that even if some ERMs belong to the category of ERM-FS, their morphology varies.…”

Comparisons of Clinical Characteristics and Surgical Outcomes of Epiretinal Membrane Foveoschisis to Typical Epiretinal Membrane

“…ERM foveoschisis was previously referred to as a “tractional type of LMH” to distinguish it from a “degenerative LMH” [ 2 , 3 , 4 , 5 , 6 ], although other names have been used [ 7 , 8 , 9 ]. Recently, several studies have reported on the clinical features [ 10 , 11 , 12 ] and postoperative changes in eyes with ERM foveoschisis [ 13 , 14 , 15 , 16 ].…”