Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 1;45(6):1108-1116.
doi: 10.1097/IAE.0000000000004418.

PATHOGENESIS OF ECTOPIC INNER FOVEAL LAYERS AND ITS IMPACT ON VISUAL RECOVERY AFTER EPIRETINAL MEMBRANE PEELING

Affiliations

PATHOGENESIS OF ECTOPIC INNER FOVEAL LAYERS AND ITS IMPACT ON VISUAL RECOVERY AFTER EPIRETINAL MEMBRANE PEELING

Mostafa Mafi et al. Retina. .

Abstract

Purpose: To determine the pathoanatomical alteration of ectopic inner foveal layers (EIFLs) and its relationship to visual recovery after epiretinal membrane peeling surgery.

Methods: Clinical charts and tracked spectral domain optical coherence tomography images of patients diagnosed with Stages 3 and 4 epiretinal membrane were reviewed and analyzed preoperatively and at 3 and 6 months postoperatively. Central macular thickness and EIFL thickness were measured at these time points. The Wilcoxon signed-rank test was used for analysis, and P < 0.05 was considered statistically significant.

Results: The study cohort consisted of 54 eyes of 54 patients, 27 of whom were female. The mean age was 69.2 years. The mean Snellen visual acuity improved from 20/50 preoperatively to 20/35 at 3 months ( P < 0.001) and remained 20/35 at 6 months, significantly better than preoperative levels ( P = 0.002). The mean preoperative EIFL thickness was 169.15 µ m and decreased to 95.70 µ m at 3 months ( P = 0.001) and 90.95 µ m at 6 months ( P = 0.02). Similarly, central macular thickness reduced from 510.00 µ m preoperatively to 444.56 µ m at 3 months ( P < 0.001) and 415.50 µ m at 6 months ( P < 0.001). Reduction in EIFL thickness was significantly correlated with improvement in logMAR visual acuity ( P =0.02) 6 months after surgery.

Conclusion: Epiretinal membrane peeling results in reduced EIFL thickness, restoration of the normal foveal pit structure, and corresponding improvement in visual acuity. Reduction in EIFL thickness is correlated with visual improvement.

Keywords: EIFL; ERM; OCT; central foveal thickness; ectopic inner foveal layers; epiretinal membrane; foveation process; optical coherence tomography; peeling; retinal imaging.

PubMed Disclaimer

References

    1. Govetto A, Lalane RA, Sarraf D, et al. 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. Mavi Yildiz A, Avci R, Yilmaz S. The predictive value of ectopic inner retinal layer staging scheme for idiopathic epiretinal membrane: surgical results at 12 months. Eye (Lond). 2021;35:2164–2172.
    1. González-Saldivar G, Berger A, Wong D, et al. Ectopic inner foveal layer classification scheme predicts visual outcomes after epiretinal membrane surgery. Retina 2020;40:710–717.
    1. Coppola M, Brambati M, Cicinelli MV, et al. The visual outcomes of idiopathic epiretinal membrane removal in eyes with ectopic inner foveal layers and preserved macular segmentation. Graefes Arch Clin Exp Ophthalmol 2021;259:2193–2201.
    1. Govetto A, Virgili G, Rodriguez FJ, et al. Functional and anatomical significance of the ectopic inner foveal layers in eyes with idiopathic epiretinal membranes: surgical results at 12 months. Retina 2019;39:347–357.

Publication types

LinkOut - more resources