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. 2025 Sep 27;45(1):393.
doi: 10.1007/s10792-025-03778-x.

Ellipsoid zone reflectivity changes after idiopathic epiretinal membrane peeling: a pilot study

Alba Chiara Termite #  1 , Pasquale Viggiano #  2 , Giacomo Boscia  2 , Lorenzo Accurso Tagano  2 , Marta Zerbinati  2 , Tommaso Festa  2 , Giulia Fracchiolla  2 , Antonio Fracchiolla  2 , Ermete Giancipoli  3 , Iaculli Cristiana  3 , Francesco Pignatelli  4 , Maria Grazia Pignataro  2 , Federico Moscara  2 , Pasquale Puzo  2 , Nicola Recchimurzo  2 , Giovanni Alessio  2 , Francesco Boscia  2
Affiliations

Ellipsoid zone reflectivity changes after idiopathic epiretinal membrane peeling: a pilot study

Alba Chiara Termite et al. Int Ophthalmol. .

Abstract

Objective: This pilot study aimed to evaluate changes in ellipsoid zone (EZ) reflectivity and best-corrected visual acuity (BCVA) following epiretinal membrane (ERM) peeling surgery in patients with stage 2 and 3 ERM.

Methods: Thirty-five patients with stage 2 and 3 ERM underwent surgical intervention. Preoperative and three-month postoperative measurements of BCVA and EZ reflectivity were taken using spectral-domain optical coherence tomography (SD-OCT). The correlation between changes in BCVA and EZ reflectivity was analyzed.

Results: BCVA significantly improved from baseline (0.67 ± 0.23 LogMAR) to three months post-surgery (0.20 ± 0.20 LogMAR) (p < 0.0001). EZ reflectivity also showed a significant increase from baseline (0.62 ± 0.18) to the follow-up visit (0.99 ± 0.30) (p < 0.0001). A significant negative correlation was observed between BCVA (logMAR) and EZ reflectivity (r = - 0.758, p = 0.001).

Conclusions: This pilot study provides preliminary evidence that EZ reflectivity correlates with visual recovery after ERM peeling surgery and suggests potential utility as a biomarker for assessing photoreceptor health. Despite the small sample size, the significant correlation between improved BCVA and increased EZ reflectivity warrants further investigation in larger, longitudinal studies.

Keywords: Ellipsoid zone reflectivity; Epiretinal membrane; Optical coherence tomography; Visual acuity.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Ethical approval: This retrospective study was conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments between January 2021 and May 2023. In Italy, retrospective studies using anonymized data do not requirespecific patient consent or ethical committee approval. However, this study was reviewed and approved by the internal review boards of the University of Bari "Aldo Moro" and theUniversity of Foggia, and the Eye Clinic “SS. Annunziata” Hospital of Taranto. Consent to participate: Despite the retrospective nature of the study, written informed consent was obtained from all participants for the use of their clinical data for research purposes. Consent for publication: Written informed consent was obtained from all individual participants for their anonymized information to be published in this article.

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