Predictive factors for postoperative visual acuity in idiopathic epiretinal membrane: a systematic review

Abstract

ABSTRACT.The aim of this study was to review the literature on predictive factors for postoperative visual acuity (VA) in surgery for idiopathic epiretinal membrane (ERM). A systematic review of the literature in the databases of PubMed and Embase was performed. The risk of bias was assessed based on predefined criteria and the results were summarized. In total, 1927 studies were retrieved of which 35 were potentially eligible. Nineteen studies were of adequate quality in terms of bias. Preoperative VA, central foveal thickness (CFT) and inner segment/outer segment (IS/OS) integrity on optical coherence tomography (OCT) were most extensively studied. Other preoperative factors studied were severity of metamorphopsia, several OCT parameters, fundus autofluorescence and multifocal electroretinogram. In the current literature, preoperative VA is the only variable consistently associated with postoperative VA. IS/OS integrity on OCT is probably associated, and the severity of metamorphopsia, cone outer segment tips integrity and fundus autofluorescence are possibly associated with postoperative VA. CFT is not associated with postoperative VA. Further studies with adequate methodological quality are needed to confirm these findings. Therefore, an overall prediction model, including different parameters, is still awaited.

Prognostic Factors Associated with Visual Outcome after Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Idiopathic Epiretinal Membrane

“…The predictive value of preoperative BCVA for postoperative BCVA has been reported several times with consistent results [1,5,6,7,8,9,13,17,21]. Our results show a similar association indicating that preoperative BCVA is a reproducible prognostic factor for postoperative BCVA.…”

“…Although pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for iERM has been shown successful in many cases, a substantial number of patients do not show VA improvement, and some patients even show a decrease in VA after surgery [1,2,3,4,5]. Therefore, many studies have looked for potential predictors of postoperative VA [6]. Associations with postoperative VA have been reported for preoperative VA [1,5,6,7,8,9], shorter duration of symptoms [1,5,7], integrity of photoreceptor inner segment/outer segment (IS/OS) line [8,10,11,12,13], and integrity of foveal cone outer segment tips (COST) line [14,15], measured with optical coherence tomography (OCT).…”

“…Therefore, many studies have looked for potential predictors of postoperative VA [6]. Associations with postoperative VA have been reported for preoperative VA [1,5,6,7,8,9], shorter duration of symptoms [1,5,7], integrity of photoreceptor inner segment/outer segment (IS/OS) line [8,10,11,12,13], and integrity of foveal cone outer segment tips (COST) line [14,15], measured with optical coherence tomography (OCT). Also, a low preoperative VA has been associated with a larger improvement in VA compared to a higher preoperative VA [5,9].…”

Associations between preoperative OCT parameters and visual outcome 3 months postoperatively in patients undergoing vitrectomy for idiopathic epiretinal membrane

“…The importance of CFT has been unclear, with authors reporting both significant and non-significant results [3, 7-9, 11, 12, 14, 15, 28, 29]. A recent systematic review concluded that, overall, CFT was not associated with postoperative visual acuity [30]. Although MRT and area have not been widely studied, other authors' findings are similar to ours.…”

Macular capillary plexuses after epiretinal membrane surgery: an optical coherence tomography angiography study

“…Despite the anatomical restoration after ERM removal, some patients continue to have persistent symptoms; thus, the identification of predictors of postoperative visual outcomes continues to be an urgent quest 2. Preoperative visual acuity, central foveal thickness (CFT) and the integrity of the ellipsoid zone and the interdigitation zone on spectral-domain optical coherence tomography (SD-OCT) have been extensively studied 2 3.…”