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Deep and superficial OCT angiography changes after macular peeling: idiopathic vs diabetic epiretinal membranes

  • Retinal Disorders
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Abstract

Background

To assess changes in deep and superficial perifoveal capillary plexus after macular peeling in idiopathic and diabetic epiretinal membrane (iERM and dERM, respectively).

Methods

Cross-sectional comparative study. We included 40 eyes from 40 patients affected by iERM (20 eyes) and dERM (20 eyes), as well as 34 eyes from 17 healthy, age-matched patients. Patients received a complete ophthalmic evaluation including axial and en-face scanning spectral-domain analysis, optical coherence tomography angiography, and microperimetry. Split-spectrum amplitude-decorrelation angiography images were obtained to quantify the deep and superficial layers of perifoveal capillary-free zone (CFZ). The main outcome measures were: (i) differences at baseline between deep and superficial CFZ in iERM and dERM vs control, and (ii) changes in deep and superficial CFZ plexus after surgery in iERM vs dERM.

Results

The deep CFZ only significantly increased in dERM at the end of the follow-up period (6 months). No statistically significant differences were found between preoperative and postoperative superficial vascular plexus in iERM or dERM. At the end of the follow-up, statistically significant differences between preoperative and postoperative ganglion cell complex (GCC) average were found only in the iERM group. Best-corrected visual acuity significantly improved after surgery both in the iERM (P = 0.0053) and dERM (P < 0.0001) groups. After 6 months, macular sensitivity increased in the iERM group, but there was no statistically significant change in the dERM group.

Conclusions

In dERM, the deep CFZ significantly increases after ILM peeling, whereas postoperative angiography changes were not significant in iERM. This could be because the impaired diabetic perifoveal capillary plexus are more sensitive to the iatrogenic damage to Müller cells, induced by peeling.

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Acknowledgments

This paper was presented at the Vail meeting 2015 in Vail (Colorado, USA)

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Authors and Affiliations

  1. Department of Biomedical Sciences, Humanitas University, Via Manzoni 113, Rozzano - Milan, 20089, Italy

    Mario R. Romano

  2. Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Via Pansini 5, 80131, Naples, Italy

    Mario R. Romano, Gilda Cennamo, Stefano Schiemer, Claudia Rossi, Federica Sparnelli & Giovanni Cennamo

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Correspondence to Mario R. Romano.

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Funding

No funding was received for this research.

Competing and financial interest

The authors declare no competing and/or financial interests in the publication of this manuscript.

All authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Writing assistance

English language editing was provided by Malini Devadas, PhD, ELS.

Design and conduct of the study (M.R.R., G.C., GL.C.), data collection (S.S., F.S.), management (G.C., M.R.R.), analysis (G.C., C.R., GL.C.), interpretation of the data (G.C., M.R.R., GL.C.) manuscript preparation (M.R.R.), and approval of the manuscript (G.C., M.R. R., GL.C.).

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Romano, M.R., Cennamo, G., Schiemer, S. et al. Deep and superficial OCT angiography changes after macular peeling: idiopathic vs diabetic epiretinal membranes. Graefes Arch Clin Exp Ophthalmol 255, 681–689 (2017). https://doi.org/10.1007/s00417-016-3534-4

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  • DOI: https://doi.org/10.1007/s00417-016-3534-4

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