Author: Micha_ Post (Poland)
Co-authors: Maria Vittoria Cicinelli, Alessandro Marchese, Emma Clara Zanzottera, Jacek Paweł Szaflik, Francesco Bandello, Michele Coppola
Analysis of functional and morphological outcomes in patients undergoing vitrectomy (PPV) with removal of idiopathic epiretinal membrane (ERM).
1. Department of Ophthalmology, San Gerardo Hospital, Monza 2. IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan 3. Department of Ophthalmology, SPKSO, Medical University of Warsaw
The functional and anatomical outcomes of patients undergoing PPV with ERM±inner limiting membrane (ILM) peeling were analyzed retrospectively. Visual acuity (logMAR, BCVA) and optical coherence tomography (OCT) tests were performed before and 3, 6, 12 months after PPV. In OCT following factors were evaluated: ERM staging according Govetto, thickness of central macular (CMT)/outer nuclear layer (ONL)/ectopic inner foveal layers (EIFL), the presence of: macular edema, cotton ball, ellipsoid zone disruption. Following surgical factors were also evaluated: surgery time, type of tamponade/dye/peeling initiation (needle/forceps), ILM peeling, phacoemulsification during PPV.
The study included 179 eyes. Preoperative BCVA was 0.49 (Snellen 20/60) ± 0.23 and post-op BCVA at 3, 6, 12 months postoperatively were 0.35 (20/44) ± 0.26, 0.27 (20/37) ± 0.20, 0.25 (20/35) ± 0.21 (p <0.05 ) respectively. The preoperative CMT was 448.68 ± 81.49 µm, posteoperatively after 3, 6, 12 months post-op: 417.91±69.46 µm, 402.04±76.53 µm, 384.20±72.01 µm, respectively (p<0.05). A thicker ONL (p=0.002), EIFL (p<0.001) and a higher endoillumination power (p=0.03) were associated with slower BCVA normalization. The ILM peeling (p=0.04) was associated with slower anatomical normalization (CMT).
Various OCT parameters and surigcal modifications of PPV may slow down anatomic and functional improvement after PPV with ERM peeling, but do not preclude good visual outcomes.