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Chou HD, Chang YC, Wu PY, Kang EYC, Chen YH, Liu L, Chen KJ, Hwang YS, Chao AN, Wu WC, Lai CC. Retinal vascular arcade angle as a biomarker for visual improvement after epiretinal membrane surgery. Eye (Lond) 2024; 38:778-785. [PMID: 37865724 PMCID: PMC10920802 DOI: 10.1038/s41433-023-02776-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/23/2023] Open
Abstract
OBJECTIVES To investigate the changes in the temporal vascular angles after epiretinal membrane (ERM) surgery and utilize the angles to predict visual outcomes. METHODS A total of 168 eyes from 84 patients with unilateral ERM who underwent vitrectomy were enrolled from a single institution. The angles of temporal venous (anglevein) and arterial arcades (angleartery) were measured on fundus photographs. The relationships between the angles and the best-corrected visual acuity (BCVA) were explored and multivariable logistic models and receiver operating characteristic (ROC) curves were analyzed to identify the factors that predicted visual outcomes. RESULTS At baseline, both angleartery and anglevein were narrower in the eyes with ERM than the fellow eyes (p < 0.001 and 0.007) but had no correlation with the baseline BCVA (p = 0.754 and 0.804). Postoperatively, the angleartery and anglevein significantly widened (both p < 0.001) and a greater BCVA improvement was associated with a greater widening of the angleartery (p = 0.029) and anglevein (p = 0.050). Multivariable logistic analyses found a narrower baseline angleartery compared to the fellow eye had a higher chance for BCVA improvement ≧ 2 lines (Odds ratio = 0.97; 95% CI, 0.94-0.99; p = 0.016). ROC curve showed the baseline difference in the angleartery between bilateral eyes predicted BCVA improvement ≧ 2 lines (area under the curve = 0.74; p = 0.035), and a 0.73 sensitivity and 0.80 specificity with a cut-off value of -27.19 degrees. CONCLUSIONS The retinal vascular angles widened after ERM surgery and the fundus photograph-derived angles may serve as a highly-accessible biomarker to predict postoperative visual outcomes.
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Affiliation(s)
- Hung-Da Chou
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Chieh Chang
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Po-Yi Wu
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Eugene Yu-Chuan Kang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsing Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Laura Liu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Jen Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yih-Shiou Hwang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - An-Ning Chao
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chun Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
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Kunavisarut P, Supawongwattana M, Patikulsila D, Choovuthayakorn J, Watanachai N, Chaikitmongkol V, Pathanapitoon K, Rothova A. Idiopathic Epiretinal Membranes: Visual Outcomes and Prognostic Factors. Turk J Ophthalmol 2022; 52:109-118. [PMID: 35481732 PMCID: PMC9069092 DOI: 10.4274/tjo.galenos.2021.09258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/18/2021] [Indexed: 12/01/2022] Open
Abstract
Objectives To evaluate the associations between anatomical changes and visual outcomes in patients with idiopathic epiretinal membrane (ERM). Materials and Methods We performed a prospective study of 130 consecutive idiopathic ERM patients and report their visual outcomes and the factors associated with visual outcome and anatomical changes. Results Of 130 eyes of 130 patients, 87 eyes underwent surgery, while the remaining 43 eyes were observed. At 6-month follow-up, the best-corrected visual acuity (BCVA) increased in the whole population. Mean Early Treatment Diabetic Retinopathy Study letter score changed from 51 to 65 in the surgical group and from 67 to 68 in the non-surgical group. The surgical group had improvement in BCVA at all ERM stages and grades of disorganization of the retinal inner layers (DRIL) (p<0.01). In multivariable analysis of the surgical group, factors associated with BCVA of ETDRS 60 letters or more were no or mild DRIL and the absence of ellipsoid zone disruption at baseline (p=0.002 and p=0.034, respectively) and this statistically significant positive correlation was still maintained at 12-month follow-up. Conclusion Baseline DRIL grade and presence of ellipsoid zone disruption were the most informative prognostic factors in patients with idiopathic ERMs. Patients with severe DRIL and/or advanced ERMs had improved vision after ERM removal.
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Affiliation(s)
- Paradee Kunavisarut
- Chiang Mai University Faculty of Medicine, Department of Ophthalmology, Chiang Mai, Thailand
| | - Montana Supawongwattana
- Chiang Mai University Faculty of Medicine, Department of Ophthalmology, Chiang Mai, Thailand
| | - Direk Patikulsila
- Chiang Mai University Faculty of Medicine, Department of Ophthalmology, Chiang Mai, Thailand
| | - Janejit Choovuthayakorn
- Chiang Mai University Faculty of Medicine, Department of Ophthalmology, Chiang Mai, Thailand
| | - Nawat Watanachai
- Chiang Mai University Faculty of Medicine, Department of Ophthalmology, Chiang Mai, Thailand
| | - Voraporn Chaikitmongkol
- Chiang Mai University Faculty of Medicine, Department of Ophthalmology, Chiang Mai, Thailand
| | - Kessara Pathanapitoon
- Chiang Mai University Faculty of Medicine, Department of Ophthalmology, Chiang Mai, Thailand
| | - Aniki Rothova
- Erasmus Medical Center, Department of Ophthalmology, Rotterdam, The Netherlands
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