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Study of foveal avascular zone by OCTA before and after idiopathic epiretinal membrane removal

Untersuchung der fovealen avaskulären Zone mittels OCTA vor und nach Entfernung idiopathischer epiretinaler Membranen

  • Vitreoretinal Disorders and Vitrectomy
  • Published:
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Summary

Background

The aim of this study was to determine the size of the foveal avascular zone (FAZ) by optical coherence tomography angiography (OCTA) after surgery for an idiopathic epiretinal membrane (ERM).

Methods

This study comprised a retrospective, observational case series. In all, 17 eyes of 17 patients with an idiopathic ERM were studied. Pars plana vitrectomy was performed with internal limiting membrane (ILM) peeling. The area of the superficial FAZ and the central macular thickness were determined by OCTA. Retinal sensitivity was measured by microperimetry.

Results

The size of the preoperative FAZ was difficult to determine because of the poor images of the capillary network. The size of the FAZ was smaller than that of the control eyes at all time points (p < 0.001). There was a significant inverse correlation between the area of the postoperative FAZ and the CMT (r = −0.480, p = 0.048 at 3 months; r = −0.565, p = 0.018 at 6 months; r = −0.534, p = 0.027 at 12 months), and between the area of the FAZ and retinal sensitivity (r = −0.622, p = 0.008 at 3 months; r = −0.578, p = 0.015 at 6 months), postoperatively.

Conclusion

The significantly small FAZ after ERM surgery indicates a macular deformity caused by a contraction of the ERM. This change persisted for at least 12 months after the surgery.

Zusammenfassung

Hintergrund

Ziel der vorliegenden Studie war es, die Größe der fovealen avaskulären Zone (FAZ) mittels optischer Kohärenztomographie-Angiographie („optical coherence tomography angiography“, OCTA) nach Operation wegen einer idiopathischen epiretinalen Membran (ERM) zu ermitteln.

Methodik

Dieser Ansatz umfasste eine retrospektive Beobachtungsstudie i. S. einer Fallserie. Insgesamt wurden 17 Augen von 17 Patienten mit idiopathischer ERM untersucht. Es wurde eine Pars-plana-Vitrektomie mit Ablösen der inneren Grenzmembran („inner limiting membrane“, ILM) durchgeführt. Unter Einsatz der OCTA wurde der Bereich der oberflächlichen FAZ und die zentrale Makuladicke („central macular thickness“, CMT) bestimmt. Die Mikroperimetrie diente der Erfassung der retinalen Sensitivität.

Ergebnisse

Die Größe der präoperativen FAZ war wegen der schlechten Qualität der Bilder des kapillaren Netzes schwierig zu ermitteln. Zu allen Zeitpunkten war die FAZ-Größe der untersuchten Patientengruppe geringer als die der Kontrollaugen (p < 0,001). Es bestand eine signifikante inverse Korrelation zwischen dem Bereich der postoperativen FAZ und der zentralen Makuladicke (r = −0,480; p = 0,048 nach 3 Monaten; r = −0,565; p = 0,018 nach 6 Monaten; r = −0,534; p = 0,027 nach 12 Monaten), und zwischen dem Bereich der FAZ und der retinalen Sensitivität (r = −0,622; p = 0,008 nach 3 Monaten; r = −0,578; p = 0,015 nach 6 Monaten) postoperativ.

Schlussfolgerung

Die in signifikanter Weise kleinere FAZ nach der ERM-Operation wies auf eine Makuladeformität hin, die durch eine Kontraktion der ERM bedingt ist. Diese Änderung bestand mindestens 12 Monate nach der Operation.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856, Chiba, Japan

    Takayuki Baba MD, Masato Kakisu MD, Tomohiro Nizawa MD, Toshiyuki Oshitari MD & Shuichi Yamamoto MD

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  1. Takayuki Baba MD
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  2. Masato Kakisu MD
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  3. Tomohiro Nizawa MD
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  4. Toshiyuki Oshitari MD
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Correspondence to Takayuki Baba MD.

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Conflict of interest

T. Baba, M. Kakisu, T. Nizawa, T. Oshitari, and S. Yamamoto declare that they have no competing interests.

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Baba, T., Kakisu, M., Nizawa, T. et al. Study of foveal avascular zone by OCTA before and after idiopathic epiretinal membrane removal. Spektrum Augenheilkd. 32, 31–38 (2018). https://doi.org/10.1007/s00717-017-0375-4

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  • DOI: https://doi.org/10.1007/s00717-017-0375-4

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