“ILM Peeling”- searching hope in ERM associated Ectopic Fovea

Author: KRISHNENDU NANDI (India)

Co-authors:

Purpose

To determine the anatomical and functional impact of internal limiting membrane (ILM) peeling in cases of Idiopathic epiretinal membrane (ERM) associated Ectopic Fovea

Setting/Venue

Tertiary Eye Care Centre, Kolkata, India

Methods

A retrospective, interventional case series of 39 eyes with Idiopathic epiretinal membrane (ERM) associated with Ectopic Fovea at presentation. The study period was between January 2016 and December 2019. Relationship between Pre-operative and Post-operative log MAR BCVA, Pre-operative and Post-operative Central Foveal thickness (CFT) evaluated. Effect of ILM peeling on Post-operative logMAR BCVA and Post surgery Ectopic fovea evaluated. Relationship of presence of Ellipsoid Zone (EZ) disruption and Recurrence of Epiretinal membrane (ERM) compared with Post-operative logMAR BCVA. Parametric and non-parametric tests are used to compare categorical and non-categorical variables and with appropriate significance (p=<0.05)

Results

Thirty-nine patients with mean age of 58.34 years and mean duration of complain of 8.97 months were included. Mean duration of follow up was 20.74 months and mean duration of Ectopic fovea resolution was 2.97months. Treatment options included Pars plana Vitrectomy and ERM removal with or without ILM peeling. Post-operative BCVA noted to be better than pre-operative value, which was statistically significant also (p value = 0.001). CFT noted to be reduced after surgery and that too was statistically significant (p value = 0.001). ILM peeling not noted to have a statistically significant relation with absence of post-operative ectopic fovea (p value = 0.256). ILM peeling noted to have good impact on logMAR BCVA but that was not statistically significant (p value = 0.456). Absence of EZ disruption noted to have significant positive association with post-operative logMAR BCVA (p value = 0.001). Faster resolution of ectopic fovea was not consistent with ILM peeling ( p value = 0.196 ). Post-operative logMAR BCVA was also not noted to be consistently poor in case of recurrence of ERM (p value = 0.146)

Conlusions

In our study internal limiting membrane (ILM) peeling noted to have significant good impact on anatomical as well as functional outcomes in Idiopathic epiretinal membrane (ERM) associated with Ectopic Fovea, though results was not statistically significant. So ILM peeling is not essential in treating cases with Ectopic fovea

Financial Disclosure

Not Applicable

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