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. 2021 Feb 5;10(2):36.
doi: 10.1167/tvst.10.2.36.

Intraoperative Retinal Changes May Predict Surgical Outcomes After Epiretinal Membrane Peeling

Lekha K Mukkamala  1 , Jaycob Avaylon  2 , R Joel Welch  1 , Amirfarbod Yazdanyar  1 , Parisa Emami-Naeini  1 , Sophia Wong  1 , Jordan Storkersen  2 , Jessica Loo  3 , David Cunefare  3 , Sina Farsiu  3 , Ala Moshiri  1 , Susanna S Park  1 , Glenn Yiu  1
Affiliations

Intraoperative Retinal Changes May Predict Surgical Outcomes After Epiretinal Membrane Peeling

Lekha K Mukkamala et al. Transl Vis Sci Technol. .

Abstract

Purpose: To investigate whether intraoperative retinal changes during epiretinal membrane (ERM) peeling affect anatomic or functional outcomes after surgery.

Methods: We measured retinal thickness using an intraoperative optical coherence tomography (iOCT) device in patients undergoing pars plana vitrectomy with membrane peeling for idiopathic ERM. Changes in intraoperative central macular thickness (iCMT) were compared with postoperative improvements in CMT and best-corrected visual acuity (VA).

Results: Twenty-seven eyes from 27 patients (mean age 68 years) underwent iOCT-assisted ERM peeling surgery. Before surgery, mean VA was logMAR 0.50 ± 0.36 (Snellen 20/63), and mean baseline CMT was 489 ± 82 µm. Mean iCMT before peeling was 477 ± 87 µm, which correlated well with preoperative CMT (P < 0.001). Mean change in iCMT was -39.6 ± 37 µm (range -116 to +77 µm). After surgery, VA improved to logMAR 0.40 ± 0.38 (Snellen 20/50) at month 1 and logMAR 0.27 ± 0.23 (Snellen 20/37) at month 3, whereas CMT decreased to 397 ± 44 µm and 396 ± 51 µm at months 1 and 3. Eyes that underwent greater amount of iCMT change (absolute value of iCMT change) were associated with greater CMT reduction at month 1 (P < 0.001) and month 3 (P = 0.010), whereas those with greater intraoperative thinning (actual iCMT change) showed a trend toward better VA outcomes at months 1 (P = 0.054) and 3 (P = 0.036).

Conclusions: Intraoperative changes in retinal thickness may predict anatomic and visual outcomes after idiopathic ERM peeling surgery.

Translational relevance: Our study suggests that intraoperative retinal tissue response to ERM peeling surgery measured by iOCT may be a prognostic indicator for restoration of retinal architecture and for visual acuity outcomes.

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Conflict of interest statement

Disclosure: L.K. Mukkamala, None; J. Avaylon, None; R.J. Welch, None; A. Yazdanyar, None; P. Emami-Naeini, None; S. Wong, None; J. Storkersen, None; J. Loo, None; D. Cunefare, None; S. Farsiu, US Patent 8,811,745; 9,299,155; 9,589,346; 10,366,492 (P); A. Moshiri, None; S.S. Park, conducts contracted research via employer Roche/Novartis; G. Yiu, received research support from Clearside Biomedical, Genentech, and Iridex, and personal fees for consultancy from Alimera, Allergan, Carl Zeiss Meditec, Clearside Biomedical, Genentech, Intergalactic Therapeutics, Iridex, Regeneron, Topcon, and Verily

Figures

Figure 1.
Figure 1.
Preoperative OCT (A, B), iOCT (gray) before (C, D) and after membrane peeling (E, F), and postoperative OCT at month 3 (G, H) of two patients exhibiting minimal (A, C, E, G) or prominent (B, D, F, H) iCMT change on iOCT after ERM peeling surgery.
Figure 2.
Figure 2.
Scatterplots comparing preoperative CMT with iCMT before membrane peeling (A), and iCMT before membrane peeling with iCMT change after membrane peeling (B).
Figure 3.
Figure 3.
Scatterplots comparing the amount of iCMT change with postoperative change in CMT at month 1 (A) and month 3 (B) after surgery, and actual iCMT change with postoperative change in CMT at month 1 (C) and month 3 (D) after surgery.
Figure 4.
Figure 4.
Scatterplots comparing the amount of iCMT change with postoperative VA improvement at month 1 (A) and month 3 (B) after surgery, and actual iCMT change with postoperative VA improvement at month 1 (C) and month 3 (D) after surgery.
See this image and copyright information in PMC

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