Inner Nuclear Layer Thickness as a Prognostic Factor for Metamorphopsia After Epiretinal Membrane Surgery

Okamoto, Fumiki; Sugiura, Yoshimi; Okamoto, Yoshifumi; Hiraoka, Takahiro; Oshika, Tetsuro

doi:10.1097/iae.0000000000000602

Cited by 96 publications

(93 citation statements)

References 37 publications

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“…Okamoto et al 7,10 reported that the preoperative aniseikonia score was significantly correlated with the thicknesses of the retinal ganglion cell (RGC) layer and the inner nuclear layer (INL). In addition, the postoperative aniseikonia scores at 3 months and 6 months were significantly correlated with the INL thickness.…”

Section: Discussionmentioning

confidence: 99%

Associations of aniseikonia with metamorphopsia and retinal displacements after epiretinal membrane surgery

Ichikawa

Imamura

Ishida

2017

Eye

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PurposeTo determine the correlation of the degree of aniseikonia with the retinal displacements and metamorphopsia in patients that have undergone successful epiretinal membrane (ERM) surgery.MethodsSubjects were 28 eyes with an ERM in 28 patients. The New Aniseikonia Test (NAT) and M-CHARTS were used to quantify the degree of preoperative and postoperative aniseikonia and metamorphopsia. We also evaluated the distance between the intersections of 2 sets of retinal vessels situated vertically or horizontally by using spectral-domain optical coherence tomography (SD-OCT) images in 28 patients.ResultsThe vertical score of M-CHARTS (MV) was not significantly improved, but the horizontal score of M-CHARTS (MH) was significantly improved at 1 week, 1 month, and 3 months postoperatively. The preoperative NAT score was significantly correlated with the preoperative MH. The NAT score at 3 months was significantly correlated with the MH at 3 months and the MV at 3 months. The preoperative NAT score was significantly correlated with the ratio of the vertical retinal displacement at 1 month and at 3 months after surgery. However, the NAT scores did not improve significantly at any postoperative times.ConclusionsThe degree of aniseikonia was significantly correlated with the degree of metamorphopsia and the tangential displacement of the retina after ERM surgery. Aniseikonia is difficult to improve and metamorphopsia may be a more sensitive parameter to detect the functional recovery after successful ERM surgery.

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Section: Discussionmentioning

confidence: 99%

Associations of aniseikonia with metamorphopsia and retinal displacements after epiretinal membrane surgery

Ichikawa

Imamura

Ishida

2017

Eye

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“…MV is thought to be associated with horizontally oriented retinal contraction. Furthermore, MV is thought to be less likely to improve in response to surgery as well as being less likely to occur because of the presence of the optic nerve which may restrict horizontal displacement of the posterior retina and also because of the directionality of the axon of the retinal ganglion cells which course horizontally rather than vertically in the posterior pole [13,21,22]. MH showed improvement in both groups (Moderate group: 0.5°, Good group: 0.37°) at the final observation time point.…”

Section: Discussionmentioning

confidence: 99%

Prospective study of vitrectomy for epiretinal membranes in patients with good best-corrected visual acuity

Nakashizuka

Kitagawa

Wakatsuki

et al. 2019

Preprint

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KEYWORDS epiretinal membrane, good visual acuity, metamorphopsia, aniseikonia, vitrectomy 2 Abstract Purpose: To evaluate the efficacy of epiretinal membrane removal in patients with good bestcorrected visual acuity (BCVA) for improving visual function and quality of life (QOL). Methods: This prospective case study compared 37 subjects with preoperative BCVA≦logMAR0.046 (Good group) to 35 patients with logMAR BCVA 0.52-0.10 (Moderate group) at 3 and 6 months. Linear mixed-effect models were used for statistical analysis. The primary outcome was the horizontal metamorphopsia score (MH) at 6 months postoperatively (post-6 M), while secondary outcomes were postoperative BCVA, vertical metamorphopsia score (MV), aniseikonia, stereopsis and central foveal thickness. In the Good group, QOL was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) at 6 and 12 months. Results: MH was significantly improved at post-3 M and post-6 M in the both groups but there were no significant differences between the two groups. MV showed no improvement at the final observation in either group. LogMAR BCVA was significantly improved at post-6 M in the Good group, which had significantly better vision than the Moderate group. Preoperative vertical and horizontal aniseikonia scores remained unchanged in the Good group at post-6 M but worsened in the Moderate group. The NEI VFQ-25 score improved in the Good group, reflecting improved general health, general vision, and mental health. Conclusions: Early epiretinal surgery was effective for MH, BCVA, aniseikonia, and QOL. BackgroundEpiretinal membrane is a translucent tissue that develops on the retinal surface and is reportedly present in 7%-11.8% individuals age 40 years and older [1,2]. Epidemiological studies conducted on the Japanese population have found that 4.0%-5.4% of individuals have epiretinal membranes, indicating that aging is a risk factor [3,4]. A recent study utilizing optical coherence tomography showed an epiretinal membrane to be present in 8.6% of post-cataract surgery patients with a mean age of 74.9 years [5]. Thus, patients with epiretinal membrane will increase as the population ages.Although the epiretinal membrane itself does not cause blindness, symptoms of metamorphopsia and aniseikonia will develop. Furthermore, best-corrected visual acuity (BCVA) will decrease with the progression of these clinical conditions. It has been reported that preoperative BCVA is associated

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“…Okamoto et al reported that preoperative MCHART score was significantly correlated with the ONL + OPL thickness using SD-OCT images. 9 Ooto et al reported that cone morphologic feature patterns in the foveal photoreceptor layer was associated with metamorphopsia, as assessed using adaptive optics scanning laser ophthalmoscopy images. 22 In this study, circularity is the parameter indicating how the ONL is close to a perfect circle, and area ratio is the parameter indicating whether the contour line of the ONL-B is irregular.…”

Section: Discussionmentioning

confidence: 99%

“…6,8 However, the longitudinal improvement in metamorphosis is not as noteworthy as that of visual acuity. 9 High-resolution spectral domain optical coherence tomography (SD-OCT), which is now the most common retinal imaging device, is widely used to investigate the changes of microstructure in the retina in patients with ERM.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Deformation of the Outer Nuclear Layer in the Epiretinal Membrane Using Spectral-Domain Optical Coherence Tomography

Takagi

Kudo

Yokota

et al. 2019

Preprint

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Background We aimed to investigate the deformation of the outer nuclear layer using optical coherence tomography in patients with epiretinal membrane (ERM) and its relationship with metamorphopsia. Methods Thirty-nine eyes from 39 patients with ERM were included in the study. Patients with the subtypes of pseudo macula hole and lamellar hole were excluded. Twenty-one fellow eyes without macular disease were included as normal controls. Forty-nine B-scan images were obtained in the range of 20 degrees around the macula using SD-OCT. The outer nuclear layer (ONL) was evaluated as a three-dimensional image (3D-ONL) reconstructed using the distance between the ONL and retinal pigment epithelium (RPE) line. The deformation of the ONL was figured at the reference plane and evaluation plane (ONL-B). The characteristic parameters of the ONL-B were defined as circularity, area ratio, and axis ratio. The correlations between these parameters and visual acuity and MCHART score ratio (MH/MV) were then evaluated. Results ONL height was significantly higher in ERM patients than in normal controls (54.1 ± 5.3 μm and 84.1 ± 12.9 μm, respectively; P<0.001). In ERM patients, the MV score was 0.53 ± 0.50, the MH score was 0.71 ± 0.61, and the distance from the RPE line to the ONL-B was 153.5 ±13.5µm. The axis of the ONL-B in normal controls and ERM patients was -6.25±21.8 and -1.28±29.1, respectively, which indicates that the ONL is horizontally long in both normal individuals and ERM patients. The circularity and area ratio were significantly smaller in ERM patients than in normal controls. In all ERM patients, MH/MV had a significant correlation with axis (r=-0.29, p=0.034), circularity (r=-0.28, p=0.044), area ratio (r=-0.47, p=0.001). Moreover, we found that the correlation was more significant if the subjects had an axis of the ONL within ± 10 degrees (n=16); the correlations of MH/MV with axis (r=-0.29, p=0.034), circularity (r=-0.53, p=0.021), and area ratio were more significant (r=-0.78, P<0.0001). Conclusion The ONL is horizontally long in normal individuals and ERM patients. The direction of metamorphopsia is correlated with the direction of ONL deformation.

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Inner Nuclear Layer Thickness as a Prognostic Factor for Metamorphopsia After Epiretinal Membrane Surgery

Abstract: Inner nuclear layer thickness was found to be a good indicator of metamorphopsia both before and after surgery and a predictor of postoperative metamorphopsia in patients with epiretinal membrane.

Cited by 96 publications

References 37 publications

Associations of aniseikonia with metamorphopsia and retinal displacements after epiretinal membrane surgery

Associations of aniseikonia with metamorphopsia and retinal displacements after epiretinal membrane surgery

Prospective study of vitrectomy for epiretinal membranes in patients with good best-corrected visual acuity

Assessment of the Deformation of the Outer Nuclear Layer in the Epiretinal Membrane Using Spectral-Domain Optical Coherence Tomography

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