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. 2025 Aug 7:19:2587-2593.
doi: 10.2147/OPTH.S524057. eCollection 2025.

En-Face OCT and Microperimetric Analysis of Intraretinal Microcysts in Eyes After Pars Plana Vitrectomy for Epiretinal Membrane

Jakub J Kaluzny  1   2 , Przemyslaw Zabel  1   3 , Karolina Anna Suwala  1   2 , Damian Jaworski  3 , Martyna Gebska-Toloczko  1   2 , Krzysztof Woznicki  4 , Renata Pek-Grzybowska  4
Affiliations

En-Face OCT and Microperimetric Analysis of Intraretinal Microcysts in Eyes After Pars Plana Vitrectomy for Epiretinal Membrane

Jakub J Kaluzny et al. Clin Ophthalmol. .

Abstract

Purpose: To compare the location of microcystic macular edema (MME) with areas of retinal nerve fiber layer (RNFL) damage in the macula detected on en-face SDOCT in eyes that underwent pars plana vitrectomy (PPV) due to the epiretinal membrane (ERM).

Patients and methods: Thirty-five eyes were enrolled at least 6 months after PPV with removal of ERM and inner limiting membrane (ILM). In each eye, en-face SDOCT and microperimetry were performed. The area of RNFL damage was measured and compared with the position of MME and correlated with the volume of retinal layers and retinal sensitivity (AT).

Results: MME was observed in 17 eyes (48.6%) in the area devoid of ILM, often in places with arcuate damage to the RNFL bundle. The mean area of RNFL damage in eyes with MME was 9.03 ± 5.3 mm2 and was significantly larger than in eyes where microcysts were not present, where it measured 3.92 ± 3.3 mm2. A significant negative correlation was observed between the area of RNFL damage and GCL volume and AT.

Conclusion: The topographic analysis of the MME position in eyes after PPV due to ERM confirmed the association of this pathology with ganglion cells and RNFL damage related to the removal of the ILM and ERM. There are probably two pathways leading to the development of MME: one starting from Muller cell damage during ILM peeling and the other due to retrograde death of ganglion cells in the areas of arcuate RNFL defects.

Keywords: en-face OCT; epiretinal membrane; ganglion cell layer; microcystic macular edema; microperimetry; retinal nerve fiber layer.

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Conflict of interest statement

The authors have not received grant support or research funding, and they do not have any proprietary interests in the materials described in the article.

Figures

Figure 1
Figure 1
Occurrence of intraretinal microcysts in the projection of the arcuate retinal nerve fiber layer defect: (A) En-face SDOCT slab below ILM shows a hyporeflective area of the arcuate RNFL lesion (arrow), (B) En-face SDOCT slab of the ONL – small hyporeflective dots corresponding to microcysts in the projection of the RNFL lesion (arrow), (C) Reduced retinal sensitivity at the site of the RNFL lesion in microperimetry (red arrow), (D) Microcysts in the inner nuclear layer on SDOCT cross-section (arrow), (E) Central SDOCT scan before vitrectomy, (F) Central SDOCT scan after vitrectomy.
Figure 2
Figure 2
Retinal sensitivity reduction in the eye after PPV with epiretinal membrane removal: (A) RNFL damage on the en-face SDOCT image. The boundaries of the damaged area are marked with arrows, (B) Microcysts located nasally to the fovea on the en-face SDOCT image (arrow), (C) Microperimetry shows two areas of reduced sensitivity, more significant from the temporal side corresponding to RMFL damage (thick red arrow) and less intense nasally to the fovea at the location of the microcyst (thin red arrow), (D) The central SDOCT section shows deep RNFL damage temporally from the fovea (thin arrow) and cysts located within the INL (thick arrow).
See this image and copyright information in PMC

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