Intraoperative Retinal Changes May Predict Surgical Outcomes After Epiretinal Membrane Peeling

Purpose: To investigate whether intraoperative retinal changes during epiretinal membrane (ERM) peeling affect anatomic or functional outcomes after surgery. Methods: We measured retinal thickness using an intraoperative optical coher-ence tomography (iOCT) device in patients undergoing pars plana vitrectomy with membrane peeling for idiopathic ERM. Changes in intraoperative central macular thickness (iCMT) were compared with postoperative improvements in CMT and best-corrected visual acuity (VA). Results: Twenty-seven eyes from 27 patients (mean age 68 years) underwent iOCT-assisted ERM peeling surgery. Before surgery, mean VA was logMAR 0.50 +/- 0.36 (Snellen 20/63), and mean baseline CMT was 489 +/- 82 mu m. Mean iCMT before peeling was 477 +/- 87 mu m, which correlated well with preoperative CMT (P < 0.001). Mean change in iCMT was & minus;39.6 +/- 37 mu m (range & minus;116 to +77 mu m). After surgery, VA improved to logMAR 0.40 +/- 0.38 (Snellen 20/50) at month 1 and logMAR 0.27 +/- 0.23 (Snellen 20/37) at month 3, whereas CMT decreased to 397 +/- 44 mu m and 396 +/- 51 mu m at months 1 and 3. Eyes that underwent greater amount of iCMT change (absolute value of iCMT change) were associated with greater CMT reduction at month 1 (P < 0.001) and month 3 (P = 0.010), whereas those with greater intraoperative thinning (actual iCMT change) showed a trend toward better VA outcomes at months 1 (P = 0.054) and 3 (P = 0.036). Conclusions: Intraoperative changes in retinal thickness may predict anatomic and visual outcomes after idiopathic ERM peeling surgery. Translational Relevance: Our study suggests that intraoperative retinal tissue response to ERM peeling surgery measured by iOCT may be a prognostic indicator for restoration of retinal architecture and for visual acuity outcomes. Superscript/Subscript Available ABSTRACT Purpose: To investigate whether intraoperative retinal changes during epiretinal membrane (ERM) peeling affect anatomic or functional outcomes after surgery. Methods: We measured retinal thickness using an intraoperative optical coherence tomography (iOCT) device in patients undergoing pars plana vitrectomy with membrane peeling for idiopathic ERM. Changes in intraoperative central macular thickness (iCMT) were compared with postoperative improvements in CMT and bestcorrected visual acuity (VA). Results: Twenty-seven eyes from 27 patients (mean age 68 years) underwent iOCTassisted ERM peeling surgery. Before surgery, mean VA was logMAR 0.50 ? 0.36 (Snellen 20/63), and mean baseline CMT was 489 ? 82 ?m. Mean iCMT before peeling was 477 ? 87 ?m, which correlated well with preoperative CMT (P < 0.001). Mean change in iCMT was ?39.6 ? 37 ?m (range ?116 to +77 ?m). After surgery, VA improved to logMAR 0.40 ? 0.38 (Snellen 20/50) at month 1 and logMAR 0.27 ? 0.23 (Snellen 20/37) at month 3, whereas CMT decreased to 397 ? 44 ?m and 396 ? 51 ?m at months 1 and 3. Eyes that underwent greater amount of iCMT change (absolute value of iCMT change) were associated with greater CMT reduction at month 1 (P < 0.001) and month 3 (P = 0.010), whereas those with greater intraoperative thinning (actual iCMT change) showed a trend toward better VA outcomes at months 1 (P = 0.054) and 3 (P = 0.036). ABSTRACT e-mail: gyiu@ucdavis.edu Received: October 16, 2020 Accepted: January 12, 2021 Published: February 23, 2021 Keywords: epiretinal membrane; intraoperative optical coherence tomography; vision Citation: Mukkamala LK, Avaylon J, Welch RJ, Yazdanyar A, Emami-Naeini P, Wong S, Storkersen J, Loo J, Cunefare D, Farsiu S, Moshiri A, Park SS, Yiu G. Intraoperative retinal changes may predict surgical outcomes after epiretinal membrane

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The study suggests that intraoperative changes in retinal thickness may predict anatomic and visual outcomes after idiopathic ERM peeling surgery. Eyes undergoing greater iCMT changes were associated with greater CMT reduction, while those undergoing greater intraoperative thinning showed a trend toward better VA outcomes.