Associations Between Macular Findings by Optical Coherence Tomography and Visual Outcomes After Epiretinal Membrane Removal

PURPOSE: To identify characteristics measured by optical coherence tomography (OCT) that are correlated with visual outcome after epiretinal membrane (ERM) removal by pars plana vitrectomy (PPV). DESIGN: Interventional, prospective, randomized case series. METHODS: One hundred and one eyes of 101 patients with idiopathic ERM underwent PPV for ERM removal. Ophthalmic evaluations included best-corrected visual acuity (BCVA) and Stratus OCT preoperatively at 3 and 6 months postoperatively. Relations between three OCT features including integrity of junction between inner and outer segments of photoreceptors (IS/OS junction), macular thickness, foveal contour and the three visual acuity parameters such as preoperative BCVAs, postoperative BCVAs, and the differences between preoperative and postoperative BCVAs (BCVA differences) were evaluated with respect to time. RESULTS: Eyes with disruption of IS/OS junction had significantly lower postoperative BCVA and BCVA differences than those without disruption (P 0.25; P .05, respectively). CONCLUSION: Photoreceptor disruption detected by OCT was found to be a predictor of poor visual outcome in eyes with idiopathic ERM, and it was found that this disruption may be irreversible. Thus, early membrane re, movals may beneficially prevent further progression of photoreceptor damage in ERM patients with photoreceptor disruption. (Am J Ophthalmol 2009;147:473-480. (C) 2009 by Elsevier Inc. All rights reserved.)Chang LK, 2008, RETINA-J RET VIT DIS, V28, P969Murakami T, 2007, AM J OPHTHALMOL, V143, P171Ko TH, 2006, ARCH OPHTHALMOL-CHIC, V124, P827Witkin AJ, 2006, OPHTHALMOLOGY, V113, P388, DOI 10.1016/j.ophtha.2005.10.047Thompson JT, 2005, RETINA-J RET VIT DIS, V25, P875Wong JG, 2005, CLIN EXP OPHTHALMOL, V33, P373Villate N, 2005, AM J OPHTHALMOL, V139, P280, DOI 10.1016/j.ajo.2004.09.029Kitaya N, 2004, AM J OPHTHALMOL, V138, P308Costa RA, 2004, INVEST OPHTH VIS SCI, V45, P2399, DOI 10.1167/iovs.04-0155Kang SW, 2004, AM J OPHTHALMOL, V137, P313, DOI 10.1016/j.ajo.2003.09.016Maia M, 2004, RETINA-J RET VIT DIS, V24, P157Kang SW, 2003, BRIT J OPHTHALMOL, V87, P1015Drexler W, 2003, ARCH OPHTHALMOL-CHIC, V121, P695Niwa T, 2003, INVEST OPHTH VIS SCI, V44, P1652, DOI 10.1167/iovs.02-0404Haritoglou C, 2003, AM J OPHTHALMOL, V135, P328Uemoto R, 2002, BRIT J OPHTHALMOL, V86, P1240Stalmans P, 2002, AM J OPHTHALMOL, V134, P282Engelbrecht NE, 2002, AM J OPHTHALMOL, V133, P89Massin P, 2000, AM J OPHTHALMOL, V130, P732Lardenoye CWTA, 2000, INVEST OPHTH VIS SCI, V41, P4048Wilkins JR, 1996, OPHTHALMOLOGY, V103, P2142MCDONALD HR, 1986, OPHTHALMOLOGY, V93, P978RICE TA, 1986, OPHTHALMOLOGY, V93, P602MARGHERIO RR, 1985, OPHTHALMOLOGY, V92, P1075MICHELS RG, 1981, AM J OPHTHALMOL, V92, P6282