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

Abstract

Purpose: Pars plana vitrectomy with internal limiting membrane peeling for idiopathic epiretinal membrane has shown varying results. More data are needed on the factors associated with visual outcome. Methods: We extracted baseline clinical characteristics, optical coherence tomography (OCT) characteristics and 3-month postoperative best-corrected visual acuity (BCVA). Linear regression analysis was used to evaluate whether baseline and OCT characteristics are associated with BCVA at 3 months as well as BCVA difference. Results: Out of 82 operated eyes, 66 (80%) had a 3-month follow-up, and 47 (71%) showed a 3-month postoperative improvement. Preoperative BCVA was an independent determinant of postoperative BCVA (r = 0.31; p < 0.01) and BCVA difference (r = 0.68; p < 0.01). Other baseline and OCT characteristics showed no independent associations with postoperative outcome. Conclusion: Better preoperative BCVA predicts better postoperative BCVA. Other baseline and OCT characteristics are not associated with visual outcome 3 months after surgery.

Intraretinal changes in idiopathic versus diabetic epiretinal membranes after macular peeling

“…As already proposed by Govetto et al [ 15 ], we believed that this association could be due to the combination of two factors: on one side, the physical traction on retinal layers with obstruction between the afferent light and the foveal photoreceptors, displacement and deformation of the photoreceptors alterating neurotransmission; on the other side, the reactive proliferation driven by Müller cells. Moreover, the lower preoperative BCVA is a negative functional prognostic factor itself [ 37 ]. The residual chronic alteration of foveal microanatomy in combination with the reactive reaction of Müller cells formation of bridge of retinal tissue in in the foveal area has been supposed to play a role in the lower postoperative functional recovery of patient with CEIFLs [ 28 ].…”

One‑year outcomes of 27G core‑pars plana vitrectomy of idiopathic epiretinal membrane

“…According to certain scholars, the preservation of the foveal photoreceptor inner/outer segment and external limited membrane may be key factors in the prognosis of BCVA ( 32 ). Laban et al ( 33 ) reported that OCT characteristics are not associated with post-operative BCVA and according to them, pre-operative BCVA is the most influential factor.…”

Spontaneous separation of secondary epiretinal membrane

“…Выбор наблюдательной тактики в отношении пациентки имеет ряд оснований [12,14,15]. Во-первых, по результатам хирургического лечения вторичной ЭРМ, ассоциированной с тромбозом ветви ЦВС, повышение остроты зрения отмечено лишь у 48,5% пациентов [14], в то время как при лечении первичной ЭРМ -в 70% случаев [8].…”

“…Во-вторых, у большинства пациентов с ЭРМ и относительно высокой остротой зрения (0,5 и выше) в отсутствие лечения зрительные функции остаются стабильными в течение 2 лет наблюдения, а снижение зрения происходит менее чем в 10% случаев [12]. В-третьих, наибольшая прибавка остроты зрения отмечается у больных с наименьшей остротой зрения до операции по поводу ЭРМ [8,15]. Кроме того, хирургия ЭРМ несет в себе такие необратимые субклинические эффекты, как фототоксичность интравитреального освещения, нейротоксичность трипанового синего в отношении ганглиозных клеток сетчатки, гибель значительного пула мюллеровых клеток в результате механической травмы при пилинге внутренней пограничной мембраны [17].…”