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Predictive value of ectopic inner foveal layer without internal limiting membrane peeling for idiopathic epiretinal membrane surgery

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Abstract

Purpose

To investigate the clinical importance of ectopic inner foveal layer (EIFL) grading (mild to severe) in patients diagnosed with idiopathic epiretinal membrane (iERM) and had pars plana vitrectomy (PPV) with solely ERM peeling.

Materials and methods

Patients diagnosed with iERMs who had undergone PPV including only ERM peeling were enrolled in the study, and follow-up findings were recorded at baseline, and at 3, 6, 12 months and final examinations. EIFL was categorized into four grades, from mild to severe. Pre- and postoperative anatomical changes were measured using spectral domain optical coherence tomography (SD-OCT) imaging. The association between EIFL and other SD-OCT parameters with best-corrected visual acuity (BCVA) was assessed before and after PPV surgery.

Results

One-hundred thirty-eight eyes of 106 patients with mild to severe EIFL were included in the study. Higher EIFL thickness was significantly correlated with lower baseline (r = 0.575, p = 0.020) and final BCVA (r = 0.748, p = 0.001). Although EIFLs continued in advanced-stage cases (stage 3 and 4) (64 eyes [82%]) at the final visit, it was observed in 8 eyes (23%) in the early stage (stage 2) of iERMs. A strong positive correlation was found between EIFL thickness and recurrence rate of ERM (r = 0.876, p < 0.001). Recurrence of ERM was detected in 27 eyes; 2 (7%) at stage 1, 3 (9%) at stage 2, 10 (23%) in stage 3, and 12 (33%) in stage 4 (p < 0.001).

Conclusion

A negative association was found between the severity of EIFL and postoperative anatomical and visual recovery. In terms of surgical timing, early stages (stages 1 and 2) may be preferred for providing good anatomical and visual recovery and a low recurrence rate following surgery.

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References

  1. Asaria R, Garnham L, Gregor ZJ, Sloper JJ (2008) A prospective study of binocular visual function before and after successful surgery to remove a unilateral epiretinal membrane. Ophthalmology 115:1930–1937

    Article  Google Scholar 

  2. Dawson SR, Shunmugam M, Williamson TH (2014) Visual acuity outcomes following surgery for idiopathic epiretinal membrane: an analysis of data from 2001 to 2011. Eye (Lond) 28:219–224

    Article  CAS  Google Scholar 

  3. Falkner-Radler CI, Glittenberg C, Hagen S, Benesch T, Binder S (2010) Spectral domain optical coherence tomography for monitoring epiretinal membrane surgery. Ophthalmology 117:798–805

    Article  Google Scholar 

  4. Michalewski J, Michalewski 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 245:1623–1631

    Article  Google Scholar 

  5. Hosoda Y, Ooto S, Hangai M, Oishi A, Yoshimura N (2015) Foveal photoreceptor deformation as a significant predictor of postoperative visual outcome in idiopathic epiretinal membrane surgery. Invest Ophthalmol Vis Sci 56:6387–6393

    Article  Google Scholar 

  6. Shiono A, Kogo J, Klose G et al (2013) Photoreceptor outer segment length: a prognostic factor for idiopathic epiretinal membrane surgery. Ophthalmology 120:788–794

    Article  Google Scholar 

  7. Rii T, Itoh Y, Inoue M, Hirakata A (2012) Foveal cone outer segment tips line and disruption artifacts in spectral-domain optical coherence tomographic images of normal eyes. Am J Ophthalmol 153:524–529

    Article  Google Scholar 

  8. Cho KH, Park SJ, Cho JH, Woo SJ, Park KH (2016) Inner-retinal irregularity index predicts postoperative visual prognosis in idiopathic epiretinal membrane. Am J Ophthalmol 168:139–149

    Article  Google Scholar 

  9. Kim JH, Kang SW, Kong MG, Ha HS (2013) Assessment of retinal layers and visual rehabilitation after epiretinal membrane removal. Graefes Arch Clin Exp Ophthalmol 251:1055–1064

    Article  Google Scholar 

  10. Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T (2015) Inner nuclear layer thickness as a prognostic factor for metamorphopsia after epiretinal membrane surgery. Retina 35:2107–2114

    Article  CAS  Google Scholar 

  11. Park SW, Byon IS, Kim HY, Lee JE, Oum BS (2015) Analysis of the ganglion cell layer and photoreceptor layer using optical coherence tomography after idiopathic epiretinal membrane surgery. Graefes Arch Clin Exp Ophthalmol 253:1829–1830

    Article  Google Scholar 

  12. Yang SH, Kim JT, Joe SG, Lee JY, Yoon YH (2015) Postoperative restoration of foveal inner retinal configuration in patients with epiretinal membrane and abnormally thick inner retina. Retina 35:111–119

    Article  Google Scholar 

  13. Govetto A, Lalane RA 3rd, Sarraf D, Figueroa MS, Hubschman JP (2017) Insights into epiretinal membranes: presence of ectopic inner foveal layers and a new optical coherence tomography staging scheme. Am J Ophthalmol 175:99–113

    Article  Google Scholar 

  14. Duker JS, Kaiser PK, Binder S et al (2013) The international vitreomacular traction study group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 120(12):2611–2619

    Article  Google Scholar 

  15. Chylack LT Jr, Wolfe JK, Singer DM et al (1993) The lens opacities classification system III: the longitudinal study of cataract study group. Arch Ophthalmol 111(6):831–836

    Article  Google Scholar 

  16. Schechet SA, DeVience E, Thompson JT (2017) The effect of internal limiting membrane peeling on idiopathic epiretinal membrane surgery, with a review of the literature. Retina 37:873–880

    Article  Google Scholar 

  17. Azuma K, Ueta T, Eguchi S, Aihara M (2017) Effects of internal limiting membrane peeling combined with removal of idiopathic epiretinal membrane: a systematic review of literature and meta-analysis. Retina 37(10):1813–1819

    Article  Google Scholar 

  18. Díaz-Valverde A, Wu L (2018) To peel or not to peel the internal limiting membrane in idiopathic epiretinal membranes. Retina 38(Suppl 1):S5–S11

    Article  Google Scholar 

  19. Govetto A, Virgili G, Rodriguez FJ, Figueroa MS, Sarraf D, Hubschman JP (2019) Functional and anatomical significance of the ectopic inner foveal layers in eyes with idiopathic epiretinal membranes: surgical results at 12 months. Retina 39(2):347–357

    Article  Google Scholar 

  20. Romano MR, Cennamo G, Cesarano I et al (2017) Changes of tangential traction after macular peeling: correlation between enface analysis and macular sensitivity. Curr Eye Res 42:780–788

    Article  Google Scholar 

  21. Yildiz AM , Avci R , Yilmaz S (2021). The predictive value of ectopic inner retinal layer staging scheme for idiopathic epiretinal membrane: surgical results at 12 months. Eye (Lond). Feb 9

  22. Kinoshita T, Kovacs KD, Wagley S, Arroyo JG (2011) Morphologic differences in epiretinal membranes on ocular coherence tomography as a predictive factor for surgical outcome. Retina 31(8):1692–1698

    Article  Google Scholar 

  23. Marmor MF, Choi SS, Zawadzki RJ, Werner JS (2008) Visual insignificance of the foveal pit reassessment of foveal hypoplasia as fovea plana. Arch Ophthalmol 126:907–913

    Article  Google Scholar 

  24. Joe SG, Lee KS, Lee JY, Hwang J-U, Kim J-G, Yoon YH (2013) Inner retinal layer thickness is the major determinant of visual acuity in patients with idiopathic epiretinal membrane. Acta Ophthalmol 91:242–243

    Article  Google Scholar 

  25. Mathews NR, Tarima S, Kim DG, Kim J (2014) Foveal contour changes following surgery for idiopathic epiretinal membrane. Invest Ophthalmol Vis Sci 55:7754–7760

    Article  Google Scholar 

  26. Ahn SJ, Ahn J, Woo SJ et al (2014) Photoreceptor change and visual outcome after idiopathic epiretinal membrane removal with or without additional internal limiting membrane peeling. Retina 34:172–181

    Article  Google Scholar 

  27. Dysli M, Ebneter A, Menke MN et al (2019) Patients with epiretinal membranes display retrograde maculopathy after surgical peeling of the internal limiting membrane. Retina 39:2132–2140

    Article  Google Scholar 

  28. Kinoshita T, Imaizumi H, Miyamoto H, Katome T, Semba K, Mitamura Y (2016) Two-year results of metamorphopsia, visual acuity, and optical coherence tomographic parameters after epiretinal membrane Surgery. Graefes Arch Clin Exp Ophthalmol 254:1041–1049

    Article  Google Scholar 

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Ophthalmology, Tuzla State Hospital, İçmeler Mahallesi, Piri Reis Caddesi, No: 74 Tuzla, 34947, Istanbul, Turkey

    Bugra Karasu

  2. University of Health Sciences, Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey

    Bugra Karasu

  3. School of Medicine Department of Ophthalmology Istanbul, Acibadem University, Istanbul, Turkey

    Ali Rıza Cenk Celebi

Authors
  1. Bugra Karasu
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  2. Ali Rıza Cenk Celebi
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Correspondence to Bugra Karasu.

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Conflict of interest

Bugra Karasu and Ali Rıza Cenk Celebi declare that they have no conflict of interest.

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 prior to every surgical procedure from all individual participants included in the study.

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Karasu, B., Celebi, A.R.C. Predictive value of ectopic inner foveal layer without internal limiting membrane peeling for idiopathic epiretinal membrane surgery. Int Ophthalmol 42, 1885–1896 (2022). https://doi.org/10.1007/s10792-021-02186-1

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  • DOI: https://doi.org/10.1007/s10792-021-02186-1

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