Abstract
Purpose: To investigate the clinical importance of ectopic inner foveal layer (EIFL) grading (mild to severe) diagnosed with idiopathic epiretinal membrane (iERM) patients who were peeled up only ERM in eyes with EIFL.Materials and Methods: Patients diagnosed with iERMs who have undergone PPV including only ERM peeling were enrolled into the study; and follow-up findings were recorded at baseline, months 3, 6, 12, and final examinations, retrospectively. EIFL was divided into four grades from mild to severe. Pre- and postoperative anatomical changes were measured by spectral domain optical coherence tomography (SD-OCT) imaging method. The association between EIFL and other SD-OCT parameters with best corrected visual acuity (BCVA) was assessed before and after PPV surgery.Results: One-hundred thirty eight eyes of 106 patients with EIFL (mild to severe) were included in the study. The higher thickness of EIFL was significantly correlated with lower baseline BCVA (r = 0.575, p = 0.020) and final BCVA (r=0.748, p= 0.001). Although, EIFLs continued in advanced stage cases (stage 3 and 4) (64 eyes (82%)) at final visit, observed in 8 eyes (23 %) in early stage (stage 2) of iERMs. Above all, a strong positive correlation was found between EIFL thickness and ERM recurrence rate (r=0.876, p <0.001). Recurrence ERM was detected in 27 eyes, which were found in 2 eyes (%7) at stage 1, 3 eyes (%9) at stage 2, 10 eyes (%23) at stage 3, and 12 eyes (%33) at stage 4 (p<0.001).Conclusion: A negative relationship was found between the severity of EIFL and postoperative anatomical and visual recovery. In terms of surgical timing, early stages (stage 1 and 2) may be preferred for providing good anatomical and visual recovery and low recurrence rate following surgery. In relation to further anatomical and visual yields, additional internal limiting membrane peeling may not be an essential procedure for early grades of iERMs (stage 1 and 2).
Predictive value of ectopic inner foveal layer without internal limiting membrane peeling for idiopathic epiretinal membrane surgery
