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Assessment of retinal layers and visual rehabilitation after epiretinal membrane removal

  • Jae Hui Kim
  • Se Woong KangEmail author
  • Min Gui Kong
  • Hyo Shin Ha
Retinal Disorders

Abstract

Background

To evaluate the changes in visual acuity, metamorphopsia, and thickness of retinal layers after epiretinal membrane (ERM) removal and to investigate factors associated with visual function.

Methods

This prospective study included 52 eyes of 52 patients who underwent surgery for idiopathic ERM. Changes in visual acuity, metamorphopsia score (M-score) using M-chart, and parafoveal thickness of each retinal layer were evaluated preoperatively and at 2-month and 6-month postoperative follow-up visits. Factors associated with visual acuity and M-score were investigated.

Results

Although continuous improvement in visual acuity and decrease in the thickness of parafoveal retinal layers following ERM removal was observed, relatively slow improvement in M-score was noted with values of 0.32 ± 0.27, 0.44 ± 0.46, and 0.23 ± 0.23, respectively at the defined time points. A preoperative increase in the thickness of parafoveal retina was mainly caused by increased thickness of inner retinal layers. Preoperative thickness of inner nuclear layer (INL) were closely associated with preoperative, postoperative visual acuity, and preoperative M-score (p = 0.001, 0.012, and 0.027, respectively).

Conclusions

Compared with the postoperative improvement in visual acuity, the postoperative improvement in metamorphopsia was a rather slow process. Parafoveal INL thickness was found to be a significant structural factor for visual acuity and metamorphopsia in ERM.

Keywords

Epiretinal membrane Visual acuity Metamorphopsia Retinal layer Inner nuclear layer 

Notes

Meeting presentation

None.

Financial support

None.

Clinical trial registration ID

NCT01474655

References

  1. 1.
    Grewing R, Mester U (1996) Results of surgery for epiretinal membranes and their recurrences. Br J Ophthalmol 80:323–326PubMedCrossRefGoogle Scholar
  2. 2.
    Margherio RR, Cox MS Jr, Trese MT, Murphy PL, Johnson J, Minor LA (1985) Removal of epimacular membranes. Ophthalmology 92:1075–1083PubMedGoogle Scholar
  3. 3.
    Pesin SR, Olk RJ, Grand MG, Boniuk I, Arribas NP, Thomas MA, Williams DF, Burgess D (1991) Vitrectomy for premacular fibroplasia. Prognostic factors, long-term follow-up, and time course of visual improvement. Ophthalmology 98:1109–1114PubMedGoogle Scholar
  4. 4.
    Rice TA, De Bustros S, Michels RG, Thompson JT, Debanne SM, Rowland DY (1986) Prognostic factors in vitrectomy for epiretinal membranes of the macula. Ophthalmology 93:602–610PubMedGoogle Scholar
  5. 5.
    Falkner-Radler CI, Glittenberg C, Hagen S, Benesch T, Binder S (2010) Spectral-domain optical coherence tomography for monitoring epiretinal membrane surgery. Ophthalmology 117:798–805PubMedCrossRefGoogle Scholar
  6. 6.
    Massin P, Allouch C, Haouchine B, Metge F, Paques M, Tangui L, Erginay A, Gaudric A (2000) Optical coherence tomography of idiopathic macular epiretinal membranes before and after surgery. Am J Ophthalmol 130:732–739PubMedCrossRefGoogle Scholar
  7. 7.
    Bouwens MD, Van Meurs JC (2003) Sine Amsler Charts: a new method for the follow-up of metamorphopsia in patients undergoing macular pucker surgery. Graefes Arch Clin Exp Ophthalmol 241:89–93PubMedCrossRefGoogle Scholar
  8. 8.
    Arndt C, Rebollo O, Seguinet S, Debruyne P, Caputo G (2007) Quantification of metamorphopsia in patients with epiretinal membranes before and after surgery. Graefes Arch Clin Exp Ophthalmol 245:1123–1129PubMedCrossRefGoogle Scholar
  9. 9.
    Okamoto F, Okamoto Y, Hiraoka T, Oshika T (2009) Effect of vitrectomy for epiretinal membrane on visual function and vision-related quality of life. Am J Ophthalmol 147(869–874):874Google Scholar
  10. 10.
    Bouwens MD, de Jong F, Mulder P, van Meurs JC (2008) Results of macular pucker surgery: 1- and 5-year follow-up. Graefes Arch Clin Exp Ophthalmol 246:1693–1697PubMedCrossRefGoogle Scholar
  11. 11.
    Ghazi-Nouri SM, Tranos PG, Rubin GS, Adams ZC, Charteris DG (2006) Visual function and quality of life following vitrectomy and epiretinal membrane peel surgery. Br J Ophthalmol 90:559–562PubMedCrossRefGoogle Scholar
  12. 12.
    Nassif N, Cense B, Park BH, Yun SH, Chen TC, Bouma BE, Tearney GJ, de Boer JF (2004) In vivo human retinal imaging by ultrahigh-speed spectral domain optical coherence tomography. Opt Lett 29:480–482PubMedCrossRefGoogle Scholar
  13. 13.
    Alam S, Zawadzki RJ, Choi S, Gerth C, Park SS, Morse L, Werner JS (2006) Clinical application of rapid serial fourier-domain optical coherence tomography for macular imaging. Ophthalmology 113:1425–1431PubMedCrossRefGoogle Scholar
  14. 14.
    Mitamura Y, Hirano K, Baba T, Yamamoto S (2009) Correlation of visual recovery with presence of photoreceptor inner/outer segment junction in optical coherence images after epiretinal membrane surgery. Br J Ophthalmol 93:171–175PubMedCrossRefGoogle Scholar
  15. 15.
    Oster SF, Mojana F, Brar M, Yuson RM, Cheng L, Freeman WR (2010) Disruption of the photoreceptor inner segment/outer segment layer on spectral domain-optical coherence tomography is a predictor of poor visual acuity in patients with epiretinal membranes. Retina 30:713–718PubMedCrossRefGoogle Scholar
  16. 16.
    Michalewski J, Michalewska Z, Cisiecki S, Nawrocki J (2007) Morphologically functional correlations of macular pathology connected with epiretinal membrane formation in spectral optical coherence tomography (SOCT). Graefes Arch Clin Exp Ophthalmol 245:1623–1631PubMedCrossRefGoogle Scholar
  17. 17.
    Suh MH, Seo JM, Park KH, Yu HG (2009) Associations between macular findings by optical coherence tomography and visual outcomes after epiretinal membrane removal. Am J Ophthalmol 147:473–480PubMedCrossRefGoogle Scholar
  18. 18.
    Lim JW (2011) Results of spectral-domain optical coherence tomography by preferential hyperacuity perimeter in patients after idiopathic epiretinal membrane surgery. Curr Eye Res 36:364–369PubMedCrossRefGoogle Scholar
  19. 19.
    Watanabe A, Arimoto S, Nishi O (2009) Correlation between metamorphopsia and epiretinal membrane optical coherence tomography findings. Ophthalmology 116:1788–1793PubMedCrossRefGoogle Scholar
  20. 20.
    Matsumoto C, Arimura E, Okuyama S, Takada S, Hashimoto S, Shimomura Y (2003) Quantification of metamorphopsia in patients with epiretinal membranes. Investig Ophthalmol Vis Sci 44:4012–4016CrossRefGoogle Scholar
  21. 21.
    Arimura E, Matsumoto C, Okuyama S, Takada S, Hashimoto S, Shimomura Y (2005) Retinal contraction and metamorphopsia scores in eyes with idiopathic epiretinal membrane. Investig Ophthalmol Vis Sci 46:2961–2966CrossRefGoogle Scholar
  22. 22.
    Gregori NZ, Feuer W, Rosenfeld PJ (2010) Novel method for analyzing snellen visual acuity measurements. Retina 30:1046–1050PubMedCrossRefGoogle Scholar
  23. 23.
    Shinoda K, Ishida S, Kawashima S, Matsuzaki T, Yamada K, Katsura H (1999) A new method for quantification of metamorphopsia in patients with epiretinal membrane. Nippon Ganka Gakkai Zasshi 103:806–810PubMedGoogle Scholar
  24. 24.
    Gaudric A, Fardeau C, Goberville M, Cohen D, Paques M, Mikol J (1993) Ablation of the internal limiting membrane, macular unfolding and visual outcome in surgery of idiopathic epimacular membranes. J Fr Ophtalmol 16:571–576PubMedGoogle Scholar
  25. 25.
    Park DW, Dugel PU, Garda J, Sipperley JO, Thach A, Sneed SR, Blaisdell J (2003) Macular pucker removal with and without internal limiting membrane peeling: pilot study. Ophthalmology 110:62–64PubMedCrossRefGoogle Scholar
  26. 26.
    Kwok A, Lai TY, Yuen KS (2005) Epiretinal membrane surgery with or without internal limiting membrane peeling. Clin Exp Ophthalmol 33:379–385CrossRefGoogle Scholar
  27. 27.
    Haritoglou C, Gandorfer A, Gass CA, Schaumberger M, Ulbig MW, Kampik A (2003) The effect of indocyanine-green on functional outcome of macular pucker surgery. Am J Ophthalmol 135:328–337PubMedCrossRefGoogle Scholar
  28. 28.
    Konstantinidis L, Uffer S, Bovey EH (2009) Ultrastructural changes of the internal limiting membrane removed during indocyanine green assisted peeling versus conventional surgery for idiopathic macular epiretinal membrane. Retina 29:380–386PubMedCrossRefGoogle Scholar
  29. 29.
    Tari SR, Vidne-Hay O, Greenstein VC, Barile GR, Hood DC, Chang S (2007) Functional and structural measurements for the assessment of internal limiting membrane peeling in idiopathic macular pucker. Retina 27:567–572PubMedCrossRefGoogle Scholar
  30. 30.
    Uemura A, Kanda S, Sakamoto Y, Kita H (2003) Visual field defects after uneventful vitrectomy for epiretinal membrane with indocyanine green-assisted internal limiting membrane peeling. Am J Ophthalmol 136:252–257PubMedCrossRefGoogle Scholar
  31. 31.
    Schatz P, Andreasson S (2010) Recovery of retinal function after recent-onset rhegmatogenous retinal detachment in relation to type of surgery. Retina 30:152–159PubMedCrossRefGoogle Scholar
  32. 32.
    Kerrison JB, Haller JA, Elman M, Miller NR (1996) Visual field loss following vitreous surgery. Arch Ophthalmol 114:564–569PubMedCrossRefGoogle Scholar
  33. 33.
    Anderson NJ, Edelhauser HF (1999) Toxicity of ocular surgical solutions. Int Ophthalmol Clin 39:91–106PubMedCrossRefGoogle Scholar
  34. 34.
    Javaheri M, Fujii GY, Rossi JV, Panzan CQ, Yanai D, Lakhanpal RR, Maia M, Khurana RN, Guven D, De Juan E Jr, Humayun MS (2007) Effect of oxygenated intraocular irrigation solutions on the electroretinogram after vitrectomy. Retina 27:87–94PubMedCrossRefGoogle Scholar
  35. 35.
    Miller SA, Landry RJ, Byrnes GA (2004) Endoilluminators: evaluation of potential retinal hazards. Appl Opt 43:1648–1653PubMedCrossRefGoogle Scholar
  36. 36.
    Tamai K, Toumoto E, Majima A (1997) Local hypothermia protects the retina from ischaemic injury in vitrectomy. Br J Ophthalmol 81:789–794PubMedCrossRefGoogle Scholar
  37. 37.
    van den Biesen PR, Berenschot T, Verdaasdonk RM, van Weelden H, van Norren D (2000) Endoillumination during vitrectomy and phototoxicity thresholds. Br J Ophthalmol 84:1372–1375PubMedCrossRefGoogle Scholar
  38. 38.
    Ferencz M, Somfai GM, Farkas A, Kovacs I, Lesch B, Recsan Z, Nemes J, Salacz G (2006) Functional assessment of the possible toxicity of indocyanine green dye in macular hole surgery. Am J Ophthalmol 142:765–770PubMedCrossRefGoogle Scholar
  39. 39.
    Engelbrecht NE, Freeman J, Sternberg P Jr, Aaberg TM Sr, Aaberg TM Jr, Martin DF, Sippy BD (2002) Retinal pigment epithelial changes after macular hole surgery with indocyanine green-assisted internal limiting membrane peeling. Am J Ophthalmol 133:89–94PubMedCrossRefGoogle Scholar
  40. 40.
    Elliott DB, Sheridan M (1988) The use of accurate visual acuity measurements in clinical anti-cataract formulation trials. Ophthalmic Physiolog Opt 8:397–401CrossRefGoogle Scholar
  41. 41.
    Ferris FL 3rd, Kassoff A, Bresnick GH, Bailey I (1982) New visual acuity charts for clinical research. Am J Ophthalmol 94:91–96PubMedGoogle Scholar
  42. 42.
    Blackhurst DW, Maguire MG (1989) Reproducibility of refraction and visual acuity measurement under a standard protocol. The Macular Photocoagulation Study Group. Retina 9:163–169PubMedCrossRefGoogle Scholar
  43. 43.
    Raasch TW, Bailey IL, Bullimore MA (1998) Repeatability of visual acuity measurement. Optom Vis Sci 75:342–348PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Jae Hui Kim
    • 1
  • Se Woong Kang
    • 1
    Email author
  • Min Gui Kong
    • 1
  • Hyo Shin Ha
    • 1
  1. 1.Department of Ophthalmology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea

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