Role of ganglion cell complex in visual recovery following surgical internal limiting membrane peeling

Pierro, Luisa; Iuliano, Lorenzo; Gagliardi, Marco; Codenotti, Marco; Ambrosi, Alessandro; Bandello, Francesco

doi:10.1007/s00417-014-2665-8

Cited by 20 publications

(13 citation statements)

References 35 publications

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“…Predicting postoperative outcomes and weighing the risks and benefits of surgery are important because there are currently no standardized surgical indicators for ERM ( Diaz-Valverde & Wu, 2018 ; Nakashizuka et al, 2019 ). Ganglion cell complex thickness, outer retina thickness, length of photoreceptor segments (PROS), and INL thickness have been shown to change after surgery and may be prognostic factors for ERM patients ( Okamoto et al, 2015 ; Pierro et al, 2015 ; Shiono et al, 2013 ; Takabatake et al, 2018 ). Previous studies have focused on the foveal retinal layers, ignoring the function of the parafoveal and perifoveal retinal layers.…”

Section: Discussionmentioning

confidence: 99%

Association between individual retinal layer thickness and visual acuity in patients with epiretinal membrane: a pilot study

Zou

Tan

Huang

et al. 2020

PeerJ

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Purpose We investigated the correlation between visual acuity (VA) and individual retinal layer thickness in the foveal, parafoveal, and perifoveal regions of patients with an idiopathic epiretinal membrane (ERM). Methods One hundred and five subjects presenting with unilateral idiopathic ERM were included in this study. We segmented each patient’s optical coherence tomography (OCT) image into seven layers and calculated the mean layer thickness in the foveal, parafoveal, and perifoveal regions using the Iowa Reference Algorithm. In 105 patients with ERM, we detected correlations between their macular regions’ individual retinal layer thickness and their best corrected VA. Thirty-one of the 105 patients with ERM underwent vitrectomy and completed six months of follow-up. We then compared the 31 surgical patients’ preoperative and postoperative individual retinal layer thickness in each macular region. Additionally, the association between preoperative individual retinal layer thickness in each macular region and VA six months post-surgery in patients with ≥ two Snellen lines of visual improvement was determined. Results Multiple linear regression analysis showed that the inner nuclear layer (INL) thickness in the foveal, parafoveal, and perifoveal region were all associated with VA in the 105 patients (R2 = 0.344, P < 0.001; R2 = 0.427, P < 0.001; and R2 = 0.340, P < 0.001, respectively). Thirty-one surgical patients 6 months post-surgery showed significantly decreased thicknesses (P ≤ 0.012) of the foveal INL, inner plexiform layer (IPL), and outer nuclear layer (ONL); the parafoveal retina nerve fiber layer (RNFL), IPL, INL, and ONL; and the perifoveal RNFL, IPL, INL, ganglion cell layer (GCL), outer plexiform layer (OPL), and photoreceptor layer (PRL). We found a weak correlation between postoperative VA and preoperative foveal and perifoveal RNFL thickness (r = 0.404 and r = 0.359, respectively), and a moderate correlation between postoperative VA and preoperative foveal and parafoveal INL thickness (r = 0.529 and r = 0.583, respectively) in the 31 surgical patients (P ≤ 0.047). The preoperative INL thickness in the foveal, parafoveal, and perifoveal regions showed a moderate to strong correlation (r = 0.507, 0.644, and 0.548, respectively), with postoperative VA in patients with ≥ 2 lines of visual improvement (P ≤ 0.038). Conclusion We detected a correlation between retinal damage and VA in the parafoveal, perifoveal, and foveal regions. Our results suggest that INL thickness in all macular regions may be a prognostic factor for postoperative VA in ERM patients.

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Section: Discussionmentioning

confidence: 99%

Association between individual retinal layer thickness and visual acuity in patients with epiretinal membrane: a pilot study

Zou

Tan

Huang

et al. 2020

PeerJ

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“…OCTA is rapidly becoming a new important imaging modality for the retina/choroid, optic nerve head and even the anterior segment. It has shown a high reliability in perfusion assessment of the superficial retinal vasculature [29,30].…”

Section: Discussionmentioning

confidence: 99%

Early Retinal Flow Changes after Vitreoretinal Surgery in Idiopathic Epiretinal Membrane Using Swept Source Optical Coherence Tomography Angiography

Mastropasqua

D’Aloisio

Viggiano

et al. 2019

JCM

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(1) Background: The aim of this observational cross-sectional work was to investigate early retinal vascular changes in patients undergoing idiopathic epiretinal membrane (iERM) surgery using swept source optical coherence tomography angiography (SS-OCTA); (2) Methods: 24 eyes of 24 patients who underwent vitrectomy with internal limiting membrane (ILM) peeling were evaluated pre- and postoperatively using SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). For each eye, five 6x6-mm OCTA volume scans were acquired by two observers independently. The en face images of superficial capillary plexus (SCP) were then exported to imageJ and a semi-automated algorithm was used for subsequent quantitative analysis. Perfusion density (PD), vessel length density (VLD), vessel diameter index (VDI) and vessel tortuosity (VT) of SCP were evaluated in both the parafoveal (2.5 mm diameter) and perifoveal areas (5.5 mm diameter); (3) Results: At OCTA analysis statistically significant differences were found between controls and diseased eyes for all parameters in parafoveal and perifoveal regions (p < 0.001; p < 0.05) except for perifoveal VLD. During 6-month follow up, both anatomical/perfusion and functional parameters showed a statistically significant improvement if compared to preoperative values. In detail, at one-month post vitrectomy, VLD and VT significantly changed in parafoveal region (p = 0.043; p = 0.045), while PD and VDI showed a trend of increase in both parafoveal and perifoveal region. At 6 months after surgery, PD, VLD and VT of parafoveal region significantly improved (p = 0.021, p = 0.018, p = 0.047 respectively). (4) Conclusions: SS-OCTA provides a quantitative and qualitative analysis of the superficial capillary plexus allowing for early vascular changes assessment after vitrectomy with iERM and ILM peeling.

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“…The ganglion cell complex (GCC=RNFL+GCL+IPL) thickness has been found to be higher in eyes with idiopathic ERM, and after surgery turns back to similar values of healthy eyes. Post-operative GCC reduction is proportionally higher than thinning of the whole retina, and this reduction is correlated with visual restoration 80…”

Section: Patient Related Outcomesmentioning

confidence: 93%

<p>Idiopathic epiretinal membrane surgery: safety, efficacy and patient related outcomes</p>

Iuliano¹,

Fogliato²,

Gorgoni³

et al. 2019

OPTH

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This review aims to give to the reader an overview selectively oriented on safety and efficacy of surgery, providing concise and direct answers about crucial questions of trainees and experts. Surgery for idiopathic epiretinal membrane (ERM) is a safe and effective procedure that can achieve long-term stable postoperative visual and anatomical improvement, with an overall low recurrence and complication rate. Young patients, with a short onset of symptoms and with better initial visual acuity achieve higher levels of visual outcome. The preoperative degree of metamorphopsia is the prognostic factor for their postoperative degree. Successful results may be obtained in eyes with specific optical coherence tomography criteria, such as thin ganglion cell layers, thin internal plexiform layer, longer photoreceptors outer segment, regular ellipsoid zone and cone outer segment tips line, and without ectopic inner foveal layer. Internal limiting membrane peeling demonstrates positive anatomical and functional outcomes, but final positions about its safety remain controversial.

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Role of ganglion cell complex in visual recovery following surgical internal limiting membrane peeling

Abstract: Ganglion cell complex thickness is higher in eyes with idiopathic ERM, and after surgery turns back to similar values of healthy eyes. Post-operative GCC reduction is proportionally higher than thinning of the whole retina, and this reduction is correlated with visual restoration.

Cited by 20 publications

References 35 publications

Association between individual retinal layer thickness and visual acuity in patients with epiretinal membrane: a pilot study

Association between individual retinal layer thickness and visual acuity in patients with epiretinal membrane: a pilot study

Early Retinal Flow Changes after Vitreoretinal Surgery in Idiopathic Epiretinal Membrane Using Swept Source Optical Coherence Tomography Angiography

<p>Idiopathic epiretinal membrane surgery: safety, efficacy and patient related outcomes</p>

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