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Observational Study
. 2024 Sep 1;44(9):1513-1520.
doi: 10.1097/IAE.0000000000004160.

EN FACE OPTICAL COHERENCE TOMOGRAPHY MORPHOLOGY OF MACULAR PUCKER CORRELATES WITH METAMORPHOPSIA: Possible Role of the Henle Fiber Layer

Andrea Govetto  1 , Sara Lucchini  1 , Jerry Sebag  2   3   4 , Fiammetta Gianfrate  1 , Stefano Ranno  1 , Elisa Carini  1 , Gianni Virgili  5 , Mario R Romano  6 , David Sarraf  7   8 , Paolo Radice  1
Affiliations
Observational Study

EN FACE OPTICAL COHERENCE TOMOGRAPHY MORPHOLOGY OF MACULAR PUCKER CORRELATES WITH METAMORPHOPSIA: Possible Role of the Henle Fiber Layer

Andrea Govetto et al. Retina. .

Erratum in

Abstract

Purpose: To describe macular pucker contraction patterns with en face optical coherence tomography (OCT), to provide a correlation with metamorphopsia scores, and to discuss the protective role of the Henle fiber layer (HFL) against tangential traction.

Methods: Retrospective, institutional, observational, and consecutive case series. Clinical charts, M-charts scores, and structural and en face OCT imaging of patients diagnosed with macular pucker were reviewed.

Results: A 120 eyes of 114 consecutive patients diagnosed with macular pucker were included. En face OCT patterns of macular pucker contraction were foveal in 51 of 120 eyes (42.5%) and extrafoveal in 69 of 120 eyes (57.5%). Foveal macular puckers had regular, a concentric, circle morphology in the HFL (46/51 eyes, 90.2%), whereas extrafoveal membranes had irregular, distorted, circular HFL morphology (62/69 eyes, 89.8%; P < 0.001). Foveal contraction morphology and regular HFL pattern, as well as extrafoveal contraction morphology and an irregular HFL pattern, highly correlated one with another (P < 0.001 in both cases). Foveal macular puckers with regular HFL patterns had significantly less vertical and horizontal M-charts scores as compared with extrafoveal membranes with irregular HFL (P < 0.001 in both cases). Ellipsoid zone and external limiting membrane defects were rare in the parafoveal region (5/120 eyes, 4.2%). Visual acuity did not correlate with metamorphopsia scores (P = 0.903).

Conclusion: En face OCT imaging identifies macular pucker contraction patterns that correlate with metamorphopsia scores and that can be used alongside the current structural OCT staging system to guide clinicians in the surgical decision-making process.

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References

    1. Ichikawa Y, Imamura Y, Ishida M. Inner nuclear layer thickness, a biomarker of metamorphopsia in epiretinal membrane, correlates with tangential retinal displacement. Am J Ophthalmol 2018;193:20–27.
    1. Ichikawa Y, Imamura Y, Ishida M. Metamorphopsia and tangential retinal displacement after epiretinal membrane surgery. Retina 2017;37:673–679.
    1. Govetto A, Lalane RA, HubschmanSarraf JPD, Figueroa MS. Insights into epiretinal membranes: presence of ectopic inner foveal layers and a new optical coherence tomography staging scheme. Am J Ophthalmol 2017;175:99–113.
    1. Ramtohul P, Cabral D, Sadda S, et al. The OCT angular sign of Henle fiber layer (HFL) hyperreflectivity (ASHH) and the pathoanatomy of the HFL in macular disease. Prog Retin Eye Res 2023;95:101135.
    1. Govetto A, Hubschman JP, Sarraf D, et al. The role of Müller cells in tractional macular disorders: an optical coherence tomography study and physical model of mechanical force transmission. Br J Ophthalmol 2020;104:466–472.

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