Highly Reflective Foveal Region in Optical Coherence Tomography in Eyes with Vitreomacular Traction or Epiretinal Membrane

Purpose: Epiretinal membrane (ERM) is a common retinal finding for patients older than 50 years. Disorganization of the retinal inner layers (DRIL) has emerged as a novel predictor of poor visual acuity (VA) in eyes with inner retinal pathology. The aim of our study is to correlate preoperative DRIL with visual outcomes after ERM surgery. Methods: Medical records and optical coherence tomography (OCT) images of 81 pseudophakic patients who underwent treatment of idiopathic ERM were reviewed. Preoperative DRIL on OCT was correlated with VA at baseline and at 3 and 6 months after ERM surgery. DRIL was defined as the loss of distinction between the ganglion cell–inner plexiform layer complex, inner nuclear layer, and outer plexiform layer. DRIL severity was based on its extent within the central 2-mm region of a transfoveal B-scan (absent/mild: <one-third, severe: >one-third horizontal width). Results: Review of preoperative OCT showed severe DRIL in 41% and absent/mild DRIL in 59%. Severe DRIL was associated with worse baseline VA ( P < .001). Preoperative VA and DRIL status at baseline were both predictors of postoperative VA at follow-up time points ( P < .001). Severe DRIL was associated with significantly less improvement in VA at 6 months (–0.23 logMAR for absent/mild vs –0.14 for severe DRIL). Conclusions: Presence of severe preoperative DRIL correlates with worse baseline VA in patients with ERM and reduced VA improvement at 6 months. DRIL can be a strong predictor of long-term poor visual outcomes in ERM surgery.

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A Comparison of Radial and Horizontal Macular Optical Coherence Tomography on Detection of Macular Pathology: A Prospective Study at an Academic Institution

Journal of VitreoRetinal Diseases ◽

10.1177/2474126421997053 ◽

2021 ◽

pp. 247412642199705

Author(s):

Halward M.J. Blegen ◽

Samuel D. Hobbs ◽

Reggie Taylor ◽

Andrew L. Plaster ◽

Paul M. Drayna

Keyword(s):

Optical Coherence Tomography ◽

Prospective Study ◽

Macular Degeneration ◽

Epiretinal Membrane ◽

Central Serous Chorioretinopathy ◽

Age Related Macular Degeneration ◽

Optical Coherence ◽

Age Related ◽

Macular Diseases ◽

A Prospective Study

Purpose: Optical coherence tomography (OCT) is useful in diagnosing and monitoring retinal pathology such as age-related macular degeneration, diabetic macular edema (DME), central serous chorioretinopathy, and epiretinal membrane, among others. This study compared the ability of horizontal (H) 25-, 13-, and 7-cut macular OCT vs 24-, 12-, and 6-cut radial (R) macular OCT in identifying various macular pathology. Methods: This was a prospective study of 161 established patients evaluated at Wilford Hall Eye Center Retina Clinic between September and October of 2019. Pathology included age-related macular degeneration, central serous chorioretinopathy, DME, and epiretinal membrane, among others. Patients obtained 25-, 13-, and 7-cut H raster OCT as well as 24-, 12-, and 6-cut R OCT. Primary outcomes were sensitivity in detecting macular fluid and each macular abnormality. Results: The 24-cut radial (R24) OCT equally or out-performed the H25 (horizontal 25-cut OCT) in detecting macular fluid across all pathological groups. Generally, a higher number of cuts correlated with better detection of fluid. In detecting any macular abnormalities, H25, R24, and R12 had 100% sensitivity. R6 OCT had near 100% sensitivity across all groups, except for DME (95%). Overall, R OCT had better sensitivity (0.960) than H OCT (0.907) in detecting macular pathology. Conclusions: R outperformed H macular OCT in detecting fluid and other abnormalities. Clinically, both scanning patterns can be used by ophthalmologists in diagnosis and management of commonly encountered macular diseases. Technicians may be able to use a variety of these scans to screen for pathology prior to physician evaluation.

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Evolution of Idiopathic Epiretinal Membrane Studied by Optical Coherence Tomography

European Journal of Ophthalmology ◽

10.1177/112067210801800620 ◽

2008 ◽

Vol 18 (6) ◽

pp. 980-988 ◽

Cited By ~ 9

Author(s):

P.G. Theodossiadis ◽

V.G. Grigoropoulos ◽

T. Kyriaki ◽

J. Emfietzoglou ◽

J. Vergados ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Epiretinal Membrane ◽

Optical Coherence ◽

Idiopathic Epiretinal Membrane

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Thickness of the Macula, Retinal Nerve Fiber Layer, and Ganglion Cell Layer in the Epiretinal Membrane: The Repeatability Study of Optical Coherence Tomography

Investigative Opthalmology & Visual Science ◽

10.1167/iovs.15-16949 ◽

2015 ◽

Vol 56 (8) ◽

pp. 4554 ◽

Cited By ~ 20

Author(s):

Haeng-Jin Lee ◽

Min-Su Kim ◽

Young-Joon Jo ◽

Jung-Yeul Kim

Keyword(s):

Optical Coherence Tomography ◽

Ganglion Cell ◽

Nerve Fiber ◽

Retinal Nerve Fiber Layer ◽

Epiretinal Membrane ◽

Ganglion Cell Layer ◽

Cell Layer ◽

Optical Coherence ◽

Fiber Layer ◽

Nerve Fiber Layer

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Natural History of Idiopathic Epiretinal Membrane in Eyes with Good Vision Assessed by Spectral-Domain Optical Coherence Tomography

Ophthalmologica ◽

10.1159/000437058 ◽

2015 ◽

Vol 234 (2) ◽

pp. 91-100 ◽

Cited By ~ 12

Author(s):

Ik Soo Byon ◽

Gang Yun Pak ◽

Han Jo Kwon ◽

Kyong Ho Kim ◽

Sung Who Park ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Natural History ◽

Visual Function ◽

Epiretinal Membrane ◽

Membrane Separation ◽

Early Stage ◽

Optical Coherence ◽

Idiopathic Epiretinal Membrane ◽

History Of

Purpose: To investigate the natural history of idiopathic epiretinal membrane (ERM) in eyes with good visual function using optical coherence tomography (OCT). Methods: Sixty-two eyes of 58 patients with idiopathic ERM, visual acuity of 20/40 or better, and no significant metamorphopsia were included. The best corrected visual acuity (BCVA), central macular thickness (CMT), membrane configuration, and ellipsoid zone signal data over 24 months were retrospectively analyzed. Based on OCT findings, ERM configurations were categorized as global attachment (GA), partial attachment (PA), pseudohole, and vitreomacular traction (VMT). Results: The mean BCVA and CMT did not change significantly between baseline and 24 months. GA, PA, pseudohole, and VMT types were observed in 33, 19, 9, and 1 eye at baseline, and in 20, 22, 10, and 1 eye at 24 months, respectively. A membrane configuration change was noted in 24 eyes (38.7%) during follow-up, and the distribution shifted from GA to the other types (p < 0.001). Six eyes had visual loss due to membrane progression, and 4 eyes had spontaneous membrane separation. Of the 10 eyes with progression or separation, 6 were of the PA type. Conclusions: Although the BCVA remains stable over 2 years in most idiopathic ERM eyes with good visual function at baseline, the membrane configuration may change, affecting visual acuity. The GA type would be an early stage, and the PA type is prone to changes in visual acuity.

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