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Hollaus M, Georgopoulos M, Iby J, Brugger J, Leingang O, Bogunovic H, Schmidt-Erfurth U, Sacu S. Analysing early changes of photoreceptor layer thickness following surgery in eyes with epiretinal membranes. Eye (Lond) 2024; 38:863-870. [PMID: 37875700 DOI: 10.1038/s41433-023-02793-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND/OBJECTIVES To analyse short-term changes of mean photoreceptor thickness (PRT) on the ETDRS-grid after vitrectomy and membrane peeling in patients with epiretinal membrane (ERM). SUBJECTS/METHODS Forty-eight patients with idiopathic ERM were included in this prospective study. Study examinations comprised best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) before surgery, 1 week (W1), 1 month (M1) and 3 months (M3) after surgery. Mean PRT was assessed using an automated algorithm and correlated with BCVA and central retinal thickness (CRT). RESULTS Regarding PRT changes of the study eye in comparison to baseline values, a significant decrease at W1 in the 1 mm, 3 mm and 6 mm area (all p-values < 0.001), at M1 (p = 0.009) and M3 (p = 0.019) in the central 1 mm area, a significant increase at M3 in the 6 mm area (p < 0.001), but no significant change at M1 in the 3 mm and 6 mm area and M3 in the 3 mm area (all p-values > 0.05) were observed. BCVA increased significantly from baseline to M3 (0.3LogMAR-0.15LogMAR, Snellen equivalent = 20/40-20/28 respectively; p < 0.001). There was no correlation between baseline PRT and BCVA at any visit after surgery, nor between PRT and BCVA at any visit (all p-values > 0.05). Decrease in PRT in the 1 mm (p < 0.001), 3 mm (p = 0.013) and 6 mm (p = 0.034) area after one week correlated with the increase in CRT (449.9 µm-462.2 µm). CONCLUSIONS Although the photoreceptor layer is morphologically affected by ERMs and after their surgical removal, it is not correlated to BCVA. Thus, patients with photoreceptor layer alterations due to ERM may still benefit from surgery and achieve good functional rehabilitation thereafter.
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Affiliation(s)
- Marlene Hollaus
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
- Vienna Clinical Trial Center, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Michael Georgopoulos
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Johannes Iby
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
- Vienna Clinical Trial Center, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Jonas Brugger
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Oliver Leingang
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
- Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Hrvoje Bogunovic
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
- Christian Doppler Lab for Artificial Intelligence in Retina, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Ursula Schmidt-Erfurth
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Stefan Sacu
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
- Vienna Clinical Trial Center, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
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Kim J, Lee JS, Chin HS. Prediction of the Expected Extent of Surgical Difficulty When Removing an Idiopathic Epiretinal Membrane. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.6.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Novel Optical Coherence Tomography Parameters as Prognostic Factors for Stage 3 Epiretinal Membranes. J Ophthalmol 2020; 2020:9861086. [PMID: 33489352 PMCID: PMC7803262 DOI: 10.1155/2020/9861086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/06/2020] [Accepted: 12/11/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose We aimed to describe the visual prognosis of eyes with ectopic inner foveal layers (EIFLs) after epiretinal membrane (ERM) surgery. Methods This retrospective study enrolled patients diagnosed with stage 3 ERM based on the EIFL staging scheme who underwent ERM surgery with a minimum follow-up period of 12 months. Central foveal thickness (CFT), EIFL thickness, and the length of the ellipsoid zone defect were evaluated at baseline and at 1 month, 6 months, and 12 months after surgery based on pre- and postoperative swept-source optical coherence tomography (OCT) images. The association of EIFL thickness and other OCT parameters with pre- and postoperative best-corrected visual acuity (BCVA) was analyzed. Results Sixty-nine eyes with stage 3 ERMs were analyzed. Preoperative BCVA was correlated with preoperative CFT (r = 0.517, p < 0.001) and preoperative EIFL thickness (r = 0.652, p < 0.001). At 12 months, postoperative BCVA was correlated negatively with preoperative CFT (r = 0.470, p=0.016) and preoperative EIFL thickness (r = 0.582, p=0.004). The improvement in BCVA was not associated with postoperative reduction in CFT (p=0.06), although it was significantly associated with postoperative reduction in EIFL thickness (r = 0.635, p=0.007). Conclusions EIFL thickness should be considered a negative prognostic factor for postoperative anatomical and functional recovery in patients with stage 3 ERMs.
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Told R, Georgopoulos M, Reiter GS, Wassermann L, Aliyeva L, Baumann L, Abela-Formanek C, Pollreisz A, Schmidt-Erfurth U, Sacu S. Intraretinal microvascular changes after ERM and ILM peeling using SSOCTA. PLoS One 2020; 15:e0242667. [PMID: 33259500 PMCID: PMC7707569 DOI: 10.1371/journal.pone.0242667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/06/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND To prospectively investigate retinal vascular changes in patients undergoing epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling using swept source optical coherence tomography angiography (SSOCTA). METHODS Consecutive patients were grouped based on ERM severity and followed using SSOCTA up to month 3 after surgical intervention. Superficial and deep foveal avascular zone (s/dFAZ) as well as foveal and parafoveal vessel density (VD) were correlated with ERM severity and visual acuity. Differences between groups were evaluated. RESULTS Significant correlations were found between ERM severity and baseline sFAZ, dFAZ and best corrected visual acuity (BCVA), central retinal subfield thickness (CST) and ΔCST (r = -0.52, r = -0.43, r = -0.42, r = 0.58, r = 0.39; all p<0.05). Vascular flow parameters did not correlate with age, peeling size, pseudophakia or CST, but correlated with intraretinal cysts presence. No associations of BCVA with any of the OCTA parameters across time were found. Significant differences between ERM severity groups 1 and 2 were found for sFAZ at baseline (p = 0.005) and at the 3-month follow-up (p = 0.014), and for dFAZ at baseline (p = 0.017). Superficial foveal and parafoveal VD were not significantly different between groups (all p>0.05). CONCLUSIONS This study clearly shows that ERM severity based on ERM staging has to be taken into account when undertaking studies in patients with idiopathic ERM using SSOCTA. Further, specific changes in the superficial and deep retinal vasculature in eyes undergoing ERM and ILM peeling were found. However, the clinical usefulness and prognostic value for post-surgical treatment BCVA of the SSOCTA-derived variables (sFAZ and dFAZ area, as well as foveal and parafoveal VD) used remains questionable.
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Affiliation(s)
- Reinhard Told
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Michael Georgopoulos
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Gregor Sebastian Reiter
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Lorenz Wassermann
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Leyla Aliyeva
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Lukas Baumann
- Department of Medical Statistics Vienna, Medical University of Vienna, Vienna, Austria
| | - Claudette Abela-Formanek
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Andreas Pollreisz
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Ursula Schmidt-Erfurth
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Stefan Sacu
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
- * E-mail:
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