Perioperative intraretinal fluid observed using optical coherence tomography in the epiretinal membrane

Abstract

Background: Postoperative intraretinal fluid (IRF) is reportedly associated with visual outcomes after epiretinal membrane (ERM) surgery. However, preoperative IRF is common, and persistent IRF would have different impact on visual function from postoperative newly developed IRF. Therefore, we aimed to investigate the incidence rate and clinical implications of perioperative IRF in ERM. Methods: Medical records of patients who underwent vitrectomy for idiopathic ERM between January 2014 and January 2017 were reviewed retrospectively. The incidence of IRF was analyzed using optical coherence tomography preoperatively and 1, 3, and 6 months postoperatively. On the basis of the presence or absence and the time of detection of IRF, patients were divided into three groups, namely preoperative IRF group, New IRF group, and IRF(−) group. Correlations of various parameters including age, sex, baseline visual acuity (VA), central subfield macular thickness, lens status, and surgical factors with IRF, along with the effect of IRF on VA, were evaluated. Results: This study included 155 eyes from 155 patients. Thirty-six (23.2%) and 49 (31.6%) eyes demonstrated preoperative and newly developed IRF, respectively. Seventy eyes (45.2%), which did not exhibit IRF during the study period, were assigned to the IRF(−) group. At baseline, the IRF(−) group showed a better VA than the other two groups. Postoperatively, VA improved significantly in all three groups. There was no difference in VA between the IRF(−) and new IRF groups at 6 months; however, the preoperative IRF group had significantly lower VA than the other two groups. Conclusion: IRF associated with ERM was frequently observed preoperatively and postoperatively, but it did not prevent postoperative vision improvement. Preoperative IRF was related to lower postoperative vision improvement.

Long-Term Microvascular Remodeling and Cystic Changes After Retinal Detachment Treated With Silicon Oil Tamponade

“…It has also been described in chronic retinal pathologies 6 or after vitrectomy for epimacular membrane. 11–16. Dormegny et al 7 also reported this pattern of cysts with a high prevalence (48%) after retinal surgery with SO tamponade.…”

Topographic Assessment of Intraretinal Cystoid Space and Its Prognostic Values in Idiopathic Epiretinal Membrane

“…IRC is also known as microcyst, cystoid macular edema (CME), intraretinal fluid, and schisis cavity in iERM. 5,14,17,18,25 Its prevalence ranged from 5.5% to 54.0% in previous studies, which is possibly attributable to the difference in methodology, including the OCT scan protocol for detection of IRC. Regarding the pathogenesis of ERM, tangential traction from Fig.…”

“…Such discrepancy arose from differences in the methodology, including the OCT scan protocol (e.g., raster scan, radial scan, or volume scan) and the area under assessment for the affected lesion. 5,14,17,18,[23][24][25] Some studies were only conducted in the localized foveal or parafoveal region. 16,18,19,23 Limited assessment of a small region using a line scan may limit our understanding of the clinical significance of IRC in iERM.…”

“…5 Intraretinal cystoid spaces (IRCs), also known as microcysts, cystic changes, and microcystic macular edema, are frequently detected on OCT before and after surgery. 5,[14][15][16][17][18][19][20][21] The inner retinal layers are affected by ERM before the outer retinal layers because membrane development occurs on the innermost retinal surface. 22 Therefore, IRC is mainly observed in the inner nuclear layer (INL), but can occur in both inner and outer retina layers, or both.…”

“…IRC was reportedly associated with a disrupted or irregular inner segment or outer segment junction. 24 Previously, several studies showed that the absence of IRC was associated with good surgical outcomes, 14,17,25 and its persistence was a poor prognostic factor. 16 By contrast, some researchers argued that IRC did not affect visual outcomes.…”