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Changes in foveal photoreceptor integrity after idiopathic epiretinal membrane surgery and its relationship with visual outcomes

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To investigate the changes in the external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IZ) integrity and their relationship with visual outcomes after idiopathic epiretinal membranes peeling.

Methods

Clinical records of 150 eyes from 144 consecutive patients who underwent vitrectomy were reviewed. The status of IZ, EZ, and ELM was assessed by spectral-domain optical coherence tomography at baseline and 1, 4, 10, and 24 months postoperatively.

Results

Sixty-one eyes presented with photoreceptor layer disruption preoperatively, and IZ disruption (40.7%) was the primary type. The best-corrected visual acuity (BCVA) in the photoreceptor disruption group was significantly lower than that in the intact group at baseline and the final follow-up. Of them, ELM + EZ + IZ disruption showed the worst BCVA (P = 0.001). After surgery, 62 eyes were observed with disruption aggravated. EZ + IZ disruption (51.0%) was the most frequent type at 1 month postoperatively. The eyes with longer symptom duration, better BCVA, earlier stage, thinner CFT at baseline, and combined cataract surgery more tended to be observed with photoreceptor damage progressed after surgery (P < 0.05). There was no significant difference in the final BCVA between the eyes with and without damage progressed (P = 0.332). Finally, 28.1% of the eyes recovered photoreceptor continuity. The eyes with foveal photoreceptor integrity restored had better BCVA than those remaining discontinuous (P < 0.001).

Conclusion

ERM-induced photoreceptor disruption mainly manifests as IZ disruption and has a negative effect on BCVA, whereas surgery mainly causes EZ and IZ disruption, which does not have a significant impact on the final BCVA.

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Funding

This study was supported by National Key Research and Development Program of China, Grant/Award Number: 2017YFA0104103.

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Authors and Affiliations

  1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, 100730, China

    Xiaohan Yang, Yanping Yu, Xijin Wu, Ke Zhang, Biying Qi, Xinbo Wang & Wu Liu

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  1. Xiaohan Yang
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  2. Yanping Yu
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Correspondence to Wu Liu.

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Ethical approval

All procedures performed in studies involving human participants adhered to the Helsinki declaration and its lateral amendments. Approval was granted by the ethical review committee of Beijing Tongren Hospital, Capital Medical University.

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Yang, X., Yu, Y., Wu, X. et al. Changes in foveal photoreceptor integrity after idiopathic epiretinal membrane surgery and its relationship with visual outcomes. Graefes Arch Clin Exp Ophthalmol 261, 925–933 (2023). https://doi.org/10.1007/s00417-022-05886-1

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