Intraretinal changes in the presence of epiretinal traction

Romano, Mario R.; Cennamo, Gilda; Amoroso, Francesca; Montorio, Daniela; Castellani, Carlo; Reibaldi, Michele; Cennamo, Giovanni

doi:10.1007/s00417-016-3413-z

Cited by 23 publications

(16 citation statements)

References 43 publications

(48 reference statements)

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“…Although this process aimed to avoid neuroretinal degeneration, it causes epiretinal and intraretinal fibrosis [ 12 , 13 ]. It is conceivable that tangential centripetal traction and the overexpression of GFAP may cause intraretinal changes, such as outer and inner neuronal damage and structural foveal alterations [ 14 ]. Continuous ectopic inner foveal layers (CEIFL) have been recently described on OCT scans as an intraretinal uninterrupted band from inner retinal layers across the fovea [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Intraretinal changes in idiopathic versus diabetic epiretinal membranes after macular peeling

et al. 2018

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IntroductionEpiretinal traction is not responsible only for epiretinal but also intraretinal changes. This study aims to describe structural and vascular intraretinal changes after macular peeling in idiopathic (iERM) vs diabetic ERM (dERM).MethodsWe conducted a prospective interventional study on forty-two eyes, 23 with iERMs and 19 with dERMs, undergoing ERM-ILM peeling. We performed SD-OCT preoperatively, 1 and 6 months postoperatively to assess central macular thickness (CMT), intraretinal cysts (IC) and/or continuous ectopic inner foveal layers (CEIFL), superficial and deep capillary free zone (CFZ) area on OCT-A. Glial fibrillary acidic protein (GFAP), as a Müller cells marker, was detected immunohistochemically on ILM specimens, to assess Müller cells iatrogenic damage.ResultsThe CEIFLs were significantly more common in iERMs (12 (52.2%) in iERMs vs 2 (10.5%) in dERMs, p = 0.004), whereas ICs in dERMs (6 (26.1%) in iERMs vs 17 (89.5%) in dERMs, p<0.001). Median preoperative and postoperative BCVA was 20/50 [20/40-20/66] and 20/33 [20/25-20/40] in iERMs and 20/100 [20/66-20/200] and 20/50 [20/50-20/66] in dERMs, respectively. Median preoperative and postoperative CMT was 423 [370–488] and 364 [329–382] μm in iERM group and 465 [447–503] and 378 [359–433] μm in dERM group, respectively. The BCVA improvement and reduction of CMT thickness were significant in both groups (p<0.001). The presence of CEIFL was associated with lower BCVA in iERMs. Deep CFZ network significantly increased only in dERMs, passing from 0.34 [0.29–0.42] mm2 preoperatively to 0.56 [0.46–0.6] mm2 at 6-month follow-up (p<0.001). The GFAP expression was significantly higher in dERMs (p = 0.001).ConclusionThe intraretinal changes are different in iERMs and dERMs, as increased expression of CEIFLs in iERMs vs ICs in dERMs. The CEIFLs are associated with worse anatomical and functional outcomes in iERMs, whereas GFAP espression in peeled ILMs is higher in dERMs.

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Section: Introductionmentioning

confidence: 99%

Intraretinal changes in idiopathic versus diabetic epiretinal membranes after macular peeling

et al. 2018

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“…It has been shown by Romano et al 18,19 that deep retinal changes can occur as a result of ERM and that these changes are correlated to functional outcomes. Although isolating specific intra-retinal phenomenon was not our current aim, a general effect on deep layer thickness is clearly seen.…”

Section: Discussionmentioning

confidence: 99%

“…2 Intra-retinal changes can develop as a result of the ERM due to retinal traction and underlying anatomical disturbances. 3 Following ERM removal surgery, further disturbances in retinal microstructure frequently develop such as alterations in foveal contour, inner retinal dimpling, and thinning or thickening of retinal areas. [4][5][6][7][8] Several attempts have been made to ascertain the nature of retinal morphological changes following surgery, using various methods.…”

Section: Introductionmentioning

confidence: 99%

Retinal layers thickness changes following epiretinal membrane surgery

Hecht

Yeshurun

Bartov

et al. 2017

Eye

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PurposeTo evaluate the time course of changes in the thickness of retinal layers after epiretinal membrane (ERM) removal surgery.MethodsA retrospective cohort study of patients following surgery for idiopathic ERM. We used new specialized image analysis software to create a thickness map of each retinal layer and analyzed changes during one year follow-up. Healthy fellow eyes were used as negative controls and the retina prior to surgery as positive control.ResultsTwenty-one patients were included with a mean age of 68±13 years. Central macular thickness decreased steadily until 6 months after surgery (25% decrease, 516±76 to 386±73 μm, P<0.001) with no further decrease between 6 and 12 months (386±73 to 390±73 μm, P=0.291). The retinal nerve fiber layer (RNFL), and the ganglion cell and inner plexiform layer (GCIPL) were most affected (57%, P<0.001 and 27%, P=0.010, respectively). The thickest region showed a more abrupt decrease of 21% at first follow-up (504±61 to 399±58 μm, P=0.001) with subsequent decrements of about 3%. Prior to surgery all retinal layers were thicker in study eyes compared with healthy control eyes (6-63%, all P<0.05).ConclusionsFollowing ERM surgery, in the course of 6 months, the macula gradually becomes thinner after which a stable state is reached. All layers appear to be affected, with the RNFL and GCIPL impacted the most. Our results provide a unique view on how the thickness of different retinal layers changes following ERM surgery.

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“…Traction has been recognized as an important prognostic factor in another study, that however focused on intra-retinal changes while measuring traction depth [21]. Moreover, many studies evaluated the relation between retinal layers morphology and BCVA, finding that the inner segment/outer segment (IS/OS) layer morphology can predict functional outcomes [22][23][24].…”

Section: Plos Onementioning

confidence: 99%

A novel quantitative analysis method for idiopathic epiretinal membrane

et al. 2021

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Purpose To introduce a novel method to quantitively analyse in three dimensions traction forces in a vast area of the ocular posterior pole. Methods Retrospective analysis of 14 eyes who underwent peeling surgery for idiopathic, symptomatic and progressive epiretinal membrane. The technique measures the shift in position of vascular crossings after surgery from a fixed point, which is the retinal pigmented epithelium. This shift is defined as the relaxation index (RI) and represents a measure of the postoperative movement of the retina due to released traction after surgery. Results Best-corrected visual acuity was significantly better than baseline at all follow ups while the RI had its maximum value at baseline. Moreover, we found a significant correlation between best-corrected visual acuity at 6 months and RI at baseline. Conclusion While all previous published methods focused on bi-dimensional changes observed in a small region, this study introduces a three-dimensional assessment of tractional forces. Future integration of RI into built-in processing software will allow systematic three-dimensional measurement of intraretinal traction.

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Intraretinal changes in the presence of epiretinal traction

Cited by 23 publications

References 43 publications

Intraretinal changes in idiopathic versus diabetic epiretinal membranes after macular peeling

Intraretinal changes in idiopathic versus diabetic epiretinal membranes after macular peeling

Retinal layers thickness changes following epiretinal membrane surgery

A novel quantitative analysis method for idiopathic epiretinal membrane

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