The Role of Disorganization of Retinal Inner Layers as Predictive Factor of Postoperative Outcome in Patients with Epiretinal Membrane

Abstract

<b><i>Purpose:</i></b> The purpose of this retrospective study was to evaluate the disorganization of the retinal inner layers (DRIL) as a potential predictive factor of postoperative visual outcome in patients with idiopathic epiretinal membrane (iERM), treated with pars plana vitrectomy (PPV). <b><i>Methods:</i></b> Participants in the study were 46 consecutive patients diagnosed with iERM, who underwent PPV. Best corrected visual acuity (BCVA) measurement and spectral-domain optical coherence tomography (SD-OCT) were performed at baseline (preoperatively), and at months 3 and 6 postoperatively. DRIL and additional OCT parameters were assessed at 1-mm-wide foveal centered area. <b><i>Results:</i></b> DRIL was observed in 47.8% of patients at baseline. There was statistically significant improvement in BCVA and central retinal thickness (CRT) between baseline and months 6 and 12 in all patients. There was a statistically significant difference in BCVA and CRT change between patients with and without DRIL at months 6 and 12 compared to baseline, showing that there was a correlation between change in BCVA or CRT and baseline DRIL. Ellipsoid zone and external limiting membrane were intact in 91.3 and 95.7%, respectively, not affecting our results. <b><i>Conclusions:</i></b> Baseline DRIL has been shown to be predictive of postoperative visual outcome in patients with iERM, treated with PPV.

Prediction of Postoperative Visual Outcome in Patients with Idiopathic Epiretinal Membrane

“…On the contrary, 3 studies supported that EZ integrity is related to higher gain in visual acuity at 6 and 12 months [12, 13, 17]. Two studies reported an association of disorganization of retinal inner layers and visual acuity change at 6 months, disagreeing with the lack of correlation found in our study [18, 19].…”

Predictive Factors for Long-Term Postoperative Visual Outcome in Patients with Macula-Off Rhegmatogenous Retinal Detachment Treated with Vitrectomy

“…The integrity of the ELM and that of the EZ are wellknown factors for visual outcomes in several retinal diseases, such as age-related macular degeneration, diabetic macular edema, retinal vein occlusion, and epiretinal membrane [21][22][23][24][25][26], although it is sometimes difficult to accurately assess the preoperative condition of the ELM and the EZ. Previous studies have found that ELM and EZ integrity has been correlated with postoperative visual outcomes in patients with RD; specifically, disrupted ELM and EZ were associated with poorer postoperative visual outcomes [7,8,14,27,28].…”

Inner Retinal Morphology and Visual Outcomes in Idiopathic Epiretinal Membrane Surgery: A Retrospective Optical Coherence Tomography Study

“…Our study further supports evidence from 2 similarly designed retrospective studies that showed baseline DRIL was predictive of postoperative visual outcome in patients with ERM. 10,11 The power of our study lies in the inclusion of only pseudophakic patients in postoperative VA outcome analysis, which eliminates postoperative lenticular changes as a confounder in functional assessment.…”

“…In addition, 12-month follow-up data were not available for most patients and precluded direct comparison with previously published reports. 10,11…”

“…Limited studies to date have investigated the predictive role of DRIL on idiopathic ERM surgery results, with preoperative DRIL reported to be correlated with poorer functional and anatomic measures. 10,11 Postoperative cataract formation is a common complication after ERM surgery, with an incidence rate varying from 12.5% to 80%, 2,12,13 and can significantly confound functional visual outcome analysis. Therefore, the purpose of our study is to further investigate the predictive value of preoperative DRIL on visual outcomes in pseudophakic patients with idiopathic ERM undergoing PPV surgery with ERM peel.…”