Long-term Surgical Outcomes of Epiretinal Membrane in Patients with Retinitis Pigmentosa

Abstract

Macular complications such as an epiretinal membrane (ERM), a cystoid macular edema and a macular hole lead to unexpected central vision impairment especially for patients with retinitis pigmentosa (RP). To evaluate the long-term surgical outcomes of pars plana vitrectomy (PPV) for ERM in patients with RP, we retrospectively reviewed the charts of a consecutive series of 10 RP patients who underwent PPV for ERM at Kyushu University Hospital. Visual acuity (VA) testing, a fundus examination, and an optical coherence tomography (OCT) analysis were conducted. The standard PPV using three sclerotomies was performed for ERM. PPV was performed in 12 eyes of 10 patients. One eye was excluded from the outcome assessment due to short period observation (18 months). There was no significantly deleterious change from the baseline to final VA between the operation eyes and the fellow eyes (P = 0.19). Moreover, morphological improvement was obtained in 9 of 11 eyes based on OCT. Our present data suggest that PPV may be tolerable in the management for ERM in RP patients over the long-term. Furthermore, the appearance of the ellipsoid zone was an important factor in the prediction of visual outcome and determination of surgical indication.

Figure 1. Images of horizontal optical coherence tomography macular scan from the typical cases.

The baseline (a) and final (b) image post-pars plana vitrectomy of a 57-year-old Japanese woman (patient number 5) with epiretinal membrane.

Figure 2. Images of horizontal optical coherence tomography macular scan from patient number 2.

The images mainly show the ellipsoid zone status in both eyes. (a,b) The baseline scan. (c,d) At 6 months post-pars plana vitrectomy (PPV). (e,f) At approximately 4 years post-PPV (51 months). (g,h) At 18 months post-PPV for the left eye (69 months).