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epiretinal membrane related vascular changes in diabetic eyes evaluated with optical coherence tomography angiography

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International Journal of Ophthalmology(English edition) 2023年第9期16卷 1503-1511页

作者： Umay Güvenç GünerÜney NurtenÜnlü Mehmet Akif Acar Dicle Hazırolan Özlem Candan Ankara Training and Research Hospital Ophthalmology Department Ankara 06800Türkiye

AIM:To evaluate the retinochoroidal microvascular circulation and anatomical structure of diabetic and nondiabetic patients with epiretinal membrane(ERM)with the help of optical coherence tomography angiography(OCT-A)and compare them with healthy control ***:In this prospective,cross-sectional study,a total of 165 eyes were evaluated,including 50 eyes of patients with diabetic ERM,54 eyes of idiopathic ERM(iERM)patients,and 61 eyes of healthy *** and disc angiography was performed by *** vessel density(VD)ratio was evaluated by dividing the VD of the foveal region by the VD of the parafoveal *** calculations were evaluated at the 95%confidence ***:Macula superficial VD values of ERM cases were lower than that in the control group,while foveal VD was higher in ERM *** deep VD values of ERM cases were lower in all quadrants,except the *** width of the foveal avascular zone(FAZ)area was significantly lower in the ERM groups,and the FAZ width was lowest in iERM *** superficial VD ratio was significantly higher in the ERM groups,but there was no significant difference between ERM *** deep VD ratio was significantly higher in the iERM group than in the control ***:Diabetic and idiopathic ERMs differ in their mechanism of formation and clinical presentation,as well as their effect on retinal vascular *** the relationship of increase of retinal thickness with vascular integrity can be demonstrated with OCT-A,then,OCT-A can be used as a guide for ERM prognosis.

关键词： diabetic macular edema epiretinal membrane macula vessel density ratio optical coherence tomography angiography

Microstructural morphology and visual acuity outcome in eyes with epiretinal membrane before,during,and after membrane peeling in intraoperative optical coherence tomography assisted macular surgery

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International Journal of Ophthalmology(English edition) 2023年第5期16卷 748-754页

作者： Melanie Weschta Moritz Pettenkofer Julian EKlaas Nikolaus Feucht Chris PLohmann Mathias Maier Department of Ophthalmology Klinikum rechts der IsarTechnische Universität MünchenIsmaninger Str.22Munich 81675Germany Jules Stein Eye Institute University of California Los Angeles100 Stein Plaza DrivewayLos AngelesCalifornia 90095USA Department of Ophthalmology Ludwig-Maximilians-Universität MünchenMathildenstr.8Munich 80336Germany Smile Eyes Augenklinik Munich Airport Terminalstraße Mitte 18Munich 85356Germany

AIM:To measure the difference of intraoperative central macular thickness(CMT)before,during,and after membrane peeling and investigate the influence of intraoperative macular stretching on postoperative best corrected visual acuity(BCVA)outcome and postoperative CMT ***:A total of 59 eyes of 59 patients who underwent vitreoretinal surgery for epiretinal membrane was *** with intraoperative optical coherence tomography(OCT)were *** of intraoperative CMT before,during,and after peeling was ***-and postoperatively obtained BCVA and spectral-domain OCT images were ***:Mean age of the patients was 70±8.13y(range 46-86y).Mean baseline BCVA was 0.49±0.27 log MAR(range 0.1-1.3).Three and six months postoperatively the mean BCVA was 0.36±0.25(P=0.01 vs baseline)and 0.38±0.35(P=0.08 vs baseline)log MAR *** stretch of the macula during surgery was 29%from baseline(range 2%-159%).Intraoperative findings of macular stretching did not correlate with visual acuity outcome within 6mo after surgery(r=-0.06,P=0.72).However,extent of macular stretching during surgery significantly correlated with less reduction of CMT at the fovea centralis(r=-0.43,Pmembrane peeling may predict the development of postoperative central retinal thickness,though there is no correlation with visual acuity development within the first 6mo postoperatively.

关键词： retinal imaging treatment surgery intraoperative optical coherence tomography epiretinal membrane

The impact of macular surgery in different grades of epiretinal membrane

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International Journal of Ophthalmology(English edition) 2017年第12期10卷 1877-1882页

作者： Cosar Batman Mehmet Citirik Yuksek Ihtisas University Koru HospitalAnkara 06520Turkey University of Health Science Ankara Ulucanlar Eye Education and Research HospitalAnkara 06230Turkey

AIM：To assess the impact of macular surgery on the functional and anatomic outcomes of the patients in different grades of epiretinal membrane（ERM）.METHODS：Seventy-one eyes of 71 patients who underwent 23-gauge transconjunctival sutureless pars plana vitrectomy for primary isolated ERM were evaluated in this ***：There were 38 females（53.5%） and 33 males（46.5%）.The average age of the patients was 68.1 y（range 42-89 y）.Mean follow up period was 14 mo（range 6-26 mo）.The cases were divided into two subgroups of cellophane maculopathy（CM） and macular pucker（MP）.An improvement was observed in the postoperative best-corrected visual acuity（BCVA）,as well as a decrement in central foveal thickness（CFT） in both groups（both of these being statistically significant;P=0.001）.In comparison between two groups,it was found that there was a significant improvement on BCVA and CFT in CM group than MP group（P=0.01）.Furthermore,the postoperative fundus findings regarding RPE alterations and macular edema were significantly higher in MP group when compared to the CM group（P=0.01）.CONCLUSION：ERM and internal limiting membrane peeling surgery can lead to a significant reduction of CFT and visual improvements in idiopathic ERM.A long-term ERM persistence will cause unrecoverable retinal damage and visual loss.

关键词： cellophane maculopathy epiretinal membrane intemal limiting membrane peeling macular pucker membranepeeling vitrectomy

Potential role of Müller cells in the pathogenesis of macropsia associated with epiretinal membrane:a hypothesis revisited

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International Journal of Ophthalmology(English edition) 2017年第11期10卷 1759-1767页

作者： Ahmet Colakoglu Solmaz Balci Aka Department of Ophthalmology Acibadem University Schoolof MedicineIstanbul 34752Turkey Department of Ophthalmology Istanbul University CerrahpasaSchool of MedicineIstanbul 34098Turkey

Pathophysiological explanations for metamorphopsia associated with retinal pathologies generally focus on photoreceptor organization disruption. However, the retinal microarchitecture is complicated, and we hypothesize that other retinal cells may also be involved. Metamorphopsia has been widely studied in eyes with epiretinal membranes and we revisit the idea that Müller cell displacement causes retinal macropsia. A Pub Med query and related article search for the macula ultrastructure under normal and pathological conditions revealed an enormous amount of information, particularly ultrahigh definition optical coherence tomography and other retinal imaging modality studies. Findings of these imaging studies support our hypothesis that Müller cells, and not cone photoreceptors, are primarily responsible for macropsia in eyes with epiretinal membranes. More specifically, we conclude that displacement of Müller cell endfeet, and not photoreceptor cones, is a more likely the explanation for retinal macropsia associated with epiretinal membranes.

关键词： macropsia metamorphopsia epiretinal membrane Müller cells

Predictive factors of epiretinal membrane in complicated rhegmatogenous retinal detachment tamponaded with silicone oil

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International Journal of Ophthalmology(English edition) 2023年第7期16卷 1110-1116页

作者： Yuan-Jie Qian Wu Xiang Yi-Meng Sun Alfira Mijit Zhi-Hao Jiang Yan-Tao Wei State Key Laboratory of Ophthalmology Zhongshan Ophthalmic CenterSun Yat-sen UniversityGuangdong Provincial Key Laboratory of Ophthalmology and Visual ScienceGuangdong Provincial Clinical Research Center for Ocular DiseasesGuangzhou 510060Guangdong ProvinceChina

AIM:To determine the incidence and predictive factors for epiretinal membrane(ERM)formation in eyes with complicated primary rhegmatogenous retinal detachment(RRD)tamponaded with silicone oil(SO).METHODS:This retrospective case-control study included 141 consecutive patients with(51 eyes)and without(90 eyes)ERM formation after primary pars plana vitrectomy(PPV)and SO tamponade for complicated *** risk factors for ERM were assessed using logistic regression ***:The prevalence of postoperative ERM was 36.2%(51/141).Multivariate logistic regression analysis showed that the risk factors for ERM in SO-tamponaded eyes included preoperative proliferative vitreoretinopathy[PVR;odds ratio(OR),2.578;95%confidence interval(CI)1.580–4.205,P<0.001],preoperative choroidal detachment(OR,4.454;95%CI 1.369–14.498,P=0.013),and photocoagulation energy(OR,2.700;95%CI 1.047–6.962,P=0.040).The duration of the preoperative symptoms,intraocular SO tamponade time,giant retinal tear,preoperative vitreous hemorrhage,preoperative bestcorrected visual acuity,number of breaks,quadrants of RRD,axial length,and photocoagulation points were not predictive factors for ERM ***:Preoperative PVR,choroidal detachment,and photocoagulation energy are risk factors of ERM formation after complicated RRD *** ophthalmic care as well as patient education are necessary for such patients with risk factors.

关键词： epiretinal membrane rhegmatogenous retinal detachment silicone oil proliferative vitreoretinopathy

Superficial foveal avascular zone area changes before and after idiopathic epiretinal membrane surgery

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International Journal of Ophthalmology(English edition) 2018年第10期11卷 1711-1715页

作者： Yo Sep Yoon Je Moon Woo Jong Eun Woo Jung Kee Min Department of Ophthalmology Ulsan University Hospital College of Medicine University of Ulsan

To investigate the foveal morphological changes and foveal avascular zone（FAZ）area before and after epiretinal membrane（ERM）***-two eyes with treatmentnaive ERM were included in this retrospective *** central foveal thickness（CFT）and FAZ area were measured via swept-source optical coherence tomography（SS-OCT）and OCT angiography pre-and *** unaffected fellow eyes were used as *** preoperative superficial FAZ area was significantly smaller in patients（0.08±0.04 mm^2）than in controls（0.33±0.09 mm^2;P〈0.001）.The postoperative superficial FAZ（0.12±0.06 mm^2）area was significantly greater than the preoperative area（P〈0.001）.The preoperative superficial FAZ area was strongly negatively correlated with CFT（P〈0.001,rho=-0.763）.ERM induced significant foveal morphological changes and reduction of the superficial FAZ *** thickness was restored and FAZ area increased ***,the process is rather slow and the recovery is incomplete.

关键词： central foveal thickness epiretinal membrane foveal avascular zone optical coherence tomography angiography

Correlation between choroidal thickness and intraocular pressure after 23-gauge vitrectomy for idiopathic epiretinal membrane

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International Journal of Ophthalmology(English edition) 2018年第11期11卷 1774-1778页

作者： Masahiro Ishida Takashi Wakakuri Yutaka Imamura Department of Ophthalmology Teikyo University School of Medicine University Hospital Mizonokuchi

AIM： To determine the relationship between the subfoveal choroidal thickness（CT） and intraocular pressure（IOP） following idiopathic epiretinal membrane（ERM） ***： Retrospective observational case series of patients who had undergone 23-gauge vitrectomy for an ERM. The measurements of CT and IOP were done at the baseline and 1 d, 1 wk, 1, 3, 6, and 12 mo after the ***： Forty-four eyes of 43 patients with a mean age of 69.8±9.5 y were studied. The CT was 200.8±86.3 μm at the baseline, 210.1±83.5 μm at 1 d, 213.2±85.4 μm at 1 wk, 203.1±84.0 μm at 1 mo, 197.5±85.5 μm at 3 mo, 197.7±84.0 μm at 6 mo, and 191.2±86.8 μm at 12 mo after surgery. The CT on day 1 and week 1 after the surgery was significantly thicker than that at the baseline CT（P=0.0023 and P〈0.0001）. The CT at 12 mo after surgery was significantly thinner than the baseline（P=0.0062）. The IOP on day 1 and week 1 were significantly lower than the baseline（P〈0.0001 and P=0.0042）. The IOP at 1, 3, 6, and 12 mo after surgery were significantly higher than the baseline IOP（P=0.0087, P=0.0023, P〈0.00051, and P〈0.0001）. The rates of changes in the CT between baseline and day 1 and week 1 were significantly and negatively correlated with the rates of change in the IOP（P〈0.0001 and P=0.046）. In the group with the IOP change rate of-30% or less at 1 d postoperatively, the change rate of CT was-21.1% to 31.2%（9.8%±12.4%） and in the group of-29% or more, it was-8.9% to 28.0%（2.6%±8.9%）. The change rate of CT in the group with the IOP change rate of-30% or less was significantly higher than the group of-29% or more（P=0.016）.CONCLUSION： CT increases soon after the ERM surgery which is probably due to the transient hypotony, showing that IOP may be a significant confounding factor for CT.

关键词： choroidal thickness vitrectomy intraocular pressure epiretinal membrane

Increased risk of postsurgical macular edema in high stage idiopathic epiretinal membranes

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Eye and Vision 2021年第1期8卷 286-294页

作者： Lorenzo Iuliano Gloria Cisa di Gresy Giovanni Fogliato Eleonora Corbelli Francesco Bandello Marco Codenotti Department of Ophthalmology Vita-Salute UniversitySan Raffaele Scientific InstituteVia Olgettina 6020132 MilanItaly

Purpose:To assess the rate of occurrence and the risk factors of postsurgical macular edema(PSME)in eyes with idiopathic epiretinal membrane(iERM)or full-thickness macular hole(FTMH).Methods:Retrospective longitudinal analysis of all subjects scheduled for vitrectomy with or without combined cataract surgery over a 6-month *** medical charts and imaging data were analyzed preoperatively and at 1,3 and 6 months after ***:From 101 patients diagnosed with iERM or FTMH,71 patients were eligible for the ***-nine eyes with iERM(69.0%)and 22 eyes with FTMH(31.0%)underwent vitrectomy either isolated(31.0%)or combined with cataract extraction(69.0%).The overall rate of PSME was 26.7%,without differences between the two groups(P=0.9479).Combined cataract extraction did not affect the overall occurrence of PSME rate in both groups(P=0.9255 in FTMH and P=0.8658 in iERM).If grouped by stage,eyes with stage 4 iERM though disclosed an increased rate of PSME(57.1%)compared to lower(1 to 3)stages(14.3%,P=0.0021),particularly when combined with cataract surgery(71.4%vs.15.4%in stages≤3,P=0.0021).The PSME odds ratio for a stage 4 iERM is 8(95%CI:1.933-33.1;P=0.0041)compared to stages 3 and ***:PSME remains a clinically relevant and frequent event after surgery for iERM and *** with stage 4 iERM have an 8-fold higher likelihood of developing PSME in a 6-month postsurgical period compared to iERM in 1-3 stages,especially when combined with cataract extraction.

关键词： epiretinal membrane Macular edema Macular hole Vitrectomy Postsurgical macular edema

Post-operative visual outcomes based on morphological staging of idiopathic epiretinal membranes on OCT

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International Journal of Ophthalmology(English edition) 2022年第12期15卷 1966-1970页

作者： Sehrish Nizar Ali Momin Roha Ahmad Choudhary MARehman Siddiqui Shiraz Hashmi Abdul Sami Memon Haroon Tayyab Department of Ophthalmology and Visual Sciences the Aga Khan University HospitalKarachiSindh 74800Pakistan

AIM:To evaluate the recently described optical coherence tomography(OCT)based classification of epiretinal membrane(ERM)and its usefulness in predicting the functional ***:A retrospective observational review of OCT scans of patients with the diagnosis of idiopathic ERM was carried out from January 2016 to June *** consecutive images diagnosed with any stage of idiopathic ERM and fulfilled the eligibility criteria were included in the *** was identified on OCT scans as a thin hyperreflective layer over the inner layers of *** scans of patients with ERM who underwent vitrectomy,were independently staged as per the new classification by two independent retinal surgeons to form a consensus on *** corrected visual acuity(BCVA)in logMAR scale and central subfield thickness(CST)on pre-and post-operative spectral domain OCT scans were the variables noted for all patients at the time of diagnosis and at 6 and 12 mo follow up visit after undergoing *** correlation coefficient was computed between BCVA(logMAR)and CST by ERM stage adjusting by baseline ***:Clinical charts of 74 patients with idiopathic ERM were *** significant improvement in BCVA overtime was observed with significant difference in median visual acuity of patients with StageⅡ-ⅣERM with P0.3).CONCLUSION:Equally significant visual outcomes of patients with ERM stagedⅡ-Ⅳand therefore can be couns

关键词： optical coherence tomography epiretinal membrane cotton ball sign vitreoschisis vitrectomy