Central Retinal Thickness and Visual Acuity Outcomes After Vitrectomy for Epiretinal Membrane With and Without Internal Limiting Membrane Peel.

Purpose: This work compares best-corrected visual acuity (BCVA) and central retinal thickness (CRT) outcome measures following pars plana vitrectomy (PPV) with and without internal limiting membrane (ILM) peel for epiretinal membrane (ERM). Methods: A retrospective cohort study was conducted of 114 eyes of 114 patients with visually significant ERM undergoing PPV with membrane peel (PPV/MP) at a single institution. CRT measurements were collected from Heidelberg and Zeiss spectral-domain optical coherence tomography imaging units. Results compared preoperative and postoperative CRT and BCVA among patients with at least 60 days of follow-up. Results: A total of 114 eyes with ERM met the inclusion criteria. Eighty-one eyes (71%) underwent PPV/MP with ILM peel and 33 eyes (29%) underwent PPV/MP without ILM peel. There was no statistically significant difference between preoperative CRT between the 2 study groups (P = .95). The mean follow-up time of eyes undergoing PPV/MP without ILM peel and with ILM peel was 391 days and 319 days, respectively. There was no statistical difference in the mean reduction of CRT between the 2 groups (P = .470). Both groups had improvement of BCVA following surgery and there was no statistical difference in final logMAR visual acuity when comparing the 2 groups (P = .738). Conclusions: There was an overall improvement of CRT and BCVA among patients undergoing PPV/MP for ERM with or without ILM peel. There was no statistically significant difference in the final BCVA or CRT between the 2 groups.

Foveal contour changes following surgery for idiopathic epiretinal membrane.

PURPOSE: We evaluated the change in foveal contour in eyes with idiopathic epiretinal membrane (ERM) before and four months following pars plana vitrectomy with internal limiting and epiretinal membrane peeling, and correlated foveal contour with best corrected visual acuity (BCVA) and optical coherence tomography (OCT) parameters. METHODS: Retrospective chart review of consecutive patients undergoing surgery with pre- and postoperative OCT. Foveal contour grading was devised according to the thickness of the fovea relative to the surrounding macula from OCT radial line scans: Grade 0, foveal depression relative to surrounding macula; Grade 1, relative flatness; and Grade 2, fovea thicker than surrounding macula. Baseline and follow-up grades were compared for change and correlated with BCVA, central retinal thickness (CRT), central subfield thickness (CST), central subfield volume (CSV), and integrity of the ellipsoid zone (EZ). RESULTS: Among 41 eyes of 41 patients, mean follow-up was 125 days. No eyes were Grade 0 at baseline; 7 of 41 eyes were Grade 0 at follow-up. Baseline Grade 1 eyes improved CRT (P < 0.001), CST (P < 0.001), CSV (P = 0.002), and BCVA (P = 0.022). Baseline Grade 2 eyes improved CRT (P < 0.001), CST (P < 0.001), and CSV (P < 0.001), but not BCVA (P = 0.369). CONCLUSIONS: We developed a novel foveal contour grading method to assess retinal contour in ERM eyes before and after surgery. In eyes with ERM and no foveal depression, the majority did not regain foveal depression following surgery even though retinal thickness improved.