Macular microvasculature features before and after vitrectomy in idiopathic macular epiretinal membrane: an OCT angiography analysis

Chen, Hui; Chi, Wei; Cai, Xiao-Juan; Deng, Yang; Jiang, Xintong; Wei, Yantao; Zhang, Shaochong

doi:10.1038/s41433-018-0272-3

Cited by 57 publications

(66 citation statements)

References 25 publications

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“…Mastropasqua [10] pointed out that the reduction of VD in SCP after surgery could correspond to the swelling of the arcuate nerve fiber layer due to the direct surgical trauma to the inner retina during the ILM grasping. However, the study of Chen [11] showed increase in the parafoveal VD in SCP after vitrectomy. Internal limiting membrane was peeled with 0.25% indocyanine green dye staining in all cases in our study, which may aggravate the damage to the SCP.…”

Section: Discussionmentioning

confidence: 90%

“…It was still controversial. Studies [8,11] also found surgery resulted in a significant change both for FVD and PRVD at 6 months post-op, however the VD was still different from the fellow eyes.…”

Section: Introductionmentioning

confidence: 96%

“…Nelis [7] and Kim [8] found that eyes with iERM can present with small FAZ area, increased foveal vessel density (FVD) and decreased parafoveal vessel density (PRVD), which reflecting the displacement of blood vessels into the fovea. Whether surgery can improve the displacement, there have been many studies [8][9][10][11]. Romano [9] found no significant differences in preoperative (pre-op) and postoperative (post-op) SCP, while Mastropasqua [10] observed a reduction in the vessel density (VD) in SCP at 1-month post-op.…”

Section: Introductionmentioning

confidence: 99%

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A study analyzing macular microvasculature features after vitrectomy using OCT angiography in patients with idiopathic macular epiretinal membrane

et al. 2020

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Background: To evaluate postoperative changes in retinal capillary plexus and to assess contributing factors in postoperative visual improvement using optical coherence tomography angiography (OCT-A) in patients with idiopathic epiretinal membrane (iERM) post membrane removal. Methods: Patients scheduled for vitrectomy and membrane peel for iERM were enrolled. 35 subjects were included for this study. OCT-A was used to measure the FAZ related parameters and the superficial and deep capillary plexus layers using 3 mm × 3 mm scans. Measurements were taken before surgery and at every post-surgical follow-up. The unaffected fellow eyes were used as controls. Evaluated factors included: BCVA, vessel density (VD) and retinal thickness (RT) in five regions, FAZ area, FAZ perimeter (PERIM), acircularity index (AI) and foveal vessel density (FD). Results: Compared with the control group, the foveal vessel density (FVD) in superficial capillary plexus (SCP) was greater in the epi-retinal membrane group (P < 0.0001), whereas both groups had comparable parafoveal vessel density (PRVD) in SCP (p > 0.05). After surgery there was a reduction in the PRVD in SCP. The FVD in DCP increased and the PRVD in DCP decreased at baseline (p < 0.001). After surgery there was an increase in PRVD in DCP. By 6 months post-op, the PRVD had no statistically significant difference compared with the control group (p > 0.05). Dvalue of LogMAR BCVA was positively correlated with pre-op LogMAR BCVA (p < 0.0001), FVD in SCP (p < 0.001). It was negatively correlated with FAZ area (P < 0.001) and PERIM (P < 0.05). Conclusions: Vitrectomy and membrane removal led to the decrease of VD in SCP and the increase of PRVD in DCP. Patients with a more severe iERM may receive greater visual improvement with surgery. Trial registration: Trial registration number (TRN) and date of registration. ChiCTR2000031289, retrospectively registered, 2020.03.26.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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A study analyzing macular microvasculature features after vitrectomy using OCT angiography in patients with idiopathic macular epiretinal membrane

et al. 2020

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“…However, reported retinal perfusion values in eyes affected by ERM are quite different. Kim et al, as well as Chen et al, investigated the parafoveal VD in SCP and DCP, demonstrating reduced VD in both plexuses compared to unaffected fellow eyes [ 10 , 11 ]. Taking into account that mechanical stress due to ERM directly affects the inner retinal layers, it would be plausible that the SCP would be primary affected.…”

Section: Discussionmentioning

confidence: 99%

“…With the recent development of optical coherence tomography angiography (OCTA), the retinal and choroidal vascular network can be assessed in vivo and in real time by creating slab-segmented angiograms, without the need for dye injection [ 6 , 7 , 8 ]. Only a few studies have evaluated vascular changes due to ERM formation and ERM removal by using OCTA, focusing especially on retinal microvascular impairment [ 9 , 10 , 11 , 12 , 13 ]. However, the role of the choroid in ERM pathogenesis is not well-known, although recent OCT- and OCTA-based studies suggest choroidal alterations from ERM and following ERM-ILM peeling [ 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Ocular Blood Flow Changes Impact Visual Acuity Gain after Surgical Treatment for Idiopathic Epiretinal Membrane

Rommel

Brinkmann²,

Sochurek³

et al. 2020

JCM

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Background: Idiopathic epiretinal membrane (iERM) is a common eye disease, which can be treated by surgical removal of the fibrotic tissue. Morphological outcome is generally evaluated by optical coherence tomography (OCT). Here, we investigate the impact of surgery on hemodynamics of the posterior pole, using OCT angiography (OCTA). Methods: Patients with unilateral iERM and indication for treatment were included. OCT and OCTA images of the posterior pole were obtained preoperatively and 3-months after 23G vitrectomy with membrane peeling. Parameters of interest included full retinal perfusion, choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP), and Haller’s layer perfusion, which were evaluated longitudinally and also compared to unaffected fellow eyes. Using these parameters, multiple regression analyses were used to predict visual outcomes. Results: Sixty-three iERM eyes were recruited, which initially showed a significant bigger central retinal thickness (p < 0.001) and total macular volume (TMV) (p < 0.001) compared to fellow eyes, while perfusion parameters were alike. Three months later, treated eyes had a statistically significant thicker subfoveal choroid (p = 0.006) and showed an increase of CCP (p = 0.003), while SLP decreased (p = 0.014). Lower preoperative TMV and higher SLP were associated with better postoperative visual outcome. Conclusion: In this OCTA study, iERM itself does not affect the choroidal circulation. However, preoperative choroidal circulation will be a biomarker to know the influence on the choroidal circulation after ERM surgery and may be considered as a predictor for visual outcome.

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Intraocular pressure might play a role in the surgical management of patients with epiretinal membrane

Lin

Horng

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Macular microvasculature features before and after vitrectomy in idiopathic macular epiretinal membrane: an OCT angiography analysis

Cited by 57 publications

References 25 publications

A study analyzing macular microvasculature features after vitrectomy using OCT angiography in patients with idiopathic macular epiretinal membrane

A study analyzing macular microvasculature features after vitrectomy using OCT angiography in patients with idiopathic macular epiretinal membrane

Ocular Blood Flow Changes Impact Visual Acuity Gain after Surgical Treatment for Idiopathic Epiretinal Membrane

Intraocular pressure might play a role in the surgical management of patients with epiretinal membrane

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