Influence of ILM peeling on macular blood flow in patients with diabetic epiretinal membrane

Abstract

Background To study the effect of intraoperative internal limiting membrane(ILM)peeling on the macular vascular structure in patients with diabetic epiretinal membrane (ERM). Methods Patients with diabetic ERM were divided into an ERM + ILM peeling group (18 eyes) and an ERM peeling group (19 eyes), all of whom underwent standard vitrectomy and were followed up until 6 months postoperatively. Best-corrected visual acuity(BCVA), Central macular thickness (CMT), Vessel density (VD) and vessel length density (VLD) of the superficial as well as deep retinal capillary plexus were compared between the two groups. Results There was no significant difference in BCVA (P > 0.05) and CMT (P > 0.05) between the two groups. In the superficial capillary plexus (SCP), the change in VD (p = 0.106) and VLD (p = 0.438) was not affected by peeling the ILM, and there was no significant difference in VD (p = 0.162) and VLD (p = 0.391) between the two groups at month 6. For the deep capillary plexus (DCP), there was an effect of ILM peeling on the changes in VD (p = 0.024) and VLD (p = 0.012); peeling of the ILM delayed the recovery time of the VD and VLD, and the VD (p = 0.003) and VLD (p = 0.000)in the ERM + ILM peeling group at postoperative month 6 were lower than those in the ERM peeling group. Conclusion Intraoperative peeling of the ILM in patients with diabetic ERM delayed the improvement of blood flow signal in the DCP but did not affect the recovery of postoperative BCVA and CMT.