scholarly journals Anatomical and Functional Outcome of Epiretinal Membrane Peeling Surgery

2021 ◽  
Author(s):  
URMISH V GOSWAMI ◽  
Gosai Jignesh Y ◽  
Modi Pratik A
Keyword(s):  
Visual Acuity ◽  
Functional Outcome ◽  
Epiretinal Membrane ◽  
Implicit Time ◽  
Care Centre ◽  
Global Improvement ◽  
Functional Changes ◽  
Membrane Peeling ◽  
Corrected Visual Acuity ◽  
Functional Visual Acuity

Abstract Background: The purpose of this study is to study the anatomical and functional outcome of epiretinal membrane peeling surgery by evaluating the visual outcomes, comparing the pre and post operative macular thickness and functional changes through electroretinogram.Methods: It is a non-randomized, open labelled, prospective study conducted in a tertiary eye care centre. The anatomical and functional outcome of epiretinal membrane peeling surgery was evaluated by comparing the preoperative BCVA, OCT and ERG with post operative results of the same, at 4 & 12 weeks after the surgery in 25 eyes. Results: There was a significant reduction in CFT (p ≤0.05) with marked improvement in vision on follow ups at 4 weeks and 12 weeks after removal of ERM with significant reduction in the macular edema. On post operative ERG, 18 (72%) patients showed global improvement in amplitudes and P1 implicit time as compared to their preoperative value while 2 (8%) patients showed global improvement in amplitude but there was still delay in P1 implicit time as similar to their preoperative value and 4 patients (16%) showed no improvement in global amplitude as well as in P1 implicit time.Conclusions: ERM peeling surgery in selected cases improves visual acuity significantly in majority of the patients. CFT and foveal architecture significantly improves with ERM peeling surgery which also explains the improvement in functional visual acuity. ERG interpretation goes along the improvement in best corrected visual acuity signifying improvement in functioning of macula.

scholarly journals Early Vascular and Functional Changes after Vitreoretinal Surgery: A Comparison between the Macular Hole and Epiretinal Membrane

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1031
Author(s):  
Rossella D’Aloisio ◽  
Paolo Carpineto ◽  
Agbéanda Aharrh-Gnama ◽  
Carla Iafigliola ◽  
Luca Cerino ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Epiretinal Membrane ◽  
Vitreoretinal Surgery ◽  
Macular Area ◽  
Functional Changes ◽  
Corrected Visual Acuity ◽  
Capillary Plexus ◽  
Best Corrected Visual Acuity ◽  
25 Gauge Vitrectomy

(1) Background: The aim of this observational comparative study was to investigate early retinal vascular and functional changes in patients undergoing vitreoretinal surgery for idiopathic epiretinal membrane (iERM) or macular hole (MH) using a widefield swept-source optical coherence tomography angiography (WSS-OCTA). (2) Methods: Forty one diseased eyes were enrolled in the study. Twenty three eyes with iERM diagnosis (ERM group) underwent 25-gauge vitrectomy with inner limiting membrane (ILM) and MER peeling, while eighteen eyes with MH (MH group) underwent 25-gauge vitrectomy with inverted flap technique. Functional and anatomical/perfusion parameters were evaluated pre- and postoperatively in all eyes by means of WSS-OCTA system, microperimetry (MP3), best corrected visual acuity assessment, central macular thickness (CMT) and MH diameter calculation. For each eye, 12 × 12 mm OCTA volume scans were acquired by a retinal specialist and a semi-automated algorithm was used for a quantitative vessel analysis of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC). In detail, perfusion density (PD) of the SCP, DCP and CC was evaluated in four circles (one central in the macular area of 5 mm diameter; three midperiphery circles (temporal, superior and inferior) of 3 mm). In addition, the vessel length density (VLD) of the SCP and DCP for the same circles was quantified. (3) Results: In the MH group, PD of the SCP significantly increased in the macular area (p = 0.018) and in the superior ring (p = 0.016); PD of the DCP significantly increased in the macular area (p = 0.015) and in the superior and inferior ring (p = 0.016) 3 months after surgery. In the ERM group, PD of the SCP and DCP significantly increased in the macular area and superior ring, respectively (p = 0.001; p = 0.032), 3 months after surgery. During follow-up there was a significant improvement in terms of functional (Best corrected visual acuity, p = 0.007 and p = 0.029; microperimetry ((MP3) 10°, p = 0.003 and p = 0.004; MP3 2°, p = 0.028 and p = 0.003 in MH group and ERM group respectively) and anatomical parameters (CMT, p = 0.049 in ERM group; hole complete closure in MH group). (4) Conclusions: After vitreoretinal surgery, early retinal vascular and functional changes can be promptly observed and quantified to monitor and potentially predict surgery outcomes. Widefield OCTA devices allow for a detailed microvasculature analysis of retina and choriocapillaris in the macular area and in the periphery, showing a different behaviour of retinal sectors in two distinct vitreoretinal disorders.

scholarly journals Rapid progression of chorioretinal atrophy in punctate inner choroiditis: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuka Kasuya ◽  
Yuji Inoue ◽  
Satoru Inoda ◽  
Yusuke Arai ◽  
Hidenori Takahashi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Epiretinal Membrane ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Japanese Woman ◽  
Rapid Progression ◽  
Chorioretinal Atrophy ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Background The chorioretinal inflammatory lesions occurring in punctate inner choroiditis evolve into punched-out atrophic scars. Typically, the progression is gradual. We report a case of highly myopic punctate inner choroiditis with rapid progression of chorioretinal atrophy. Case presentation A 48-year-old Japanese woman with high myopia presented with decreased visual acuity. Best-corrected visual acuity was 20/28 in the right eye and 20/16 in the left eye; axial length was 29.0 mm and 28.7 mm, respectively. Fundoscopy revealed an epiretinal membrane in the left eye. Three years later, the best-corrected visual acuity in the left eye had decreased to 20/33; at this time, the patient underwent vitrectomy with epiretinal membrane and internal limiting membrane peeling in this eye. Six months later, the best-corrected visual acuity in the left eye decreased suddenly to 20/100. Optical coherence tomography showed a nodule-like lesion in the outer retina with disruption of the retinal pigment epithelium and a focally thickened choroid, compatible with PIC. One month later, the choroidal thickness had decreased. The central chorioretinal atrophy expanded rapidly at a rate of 0.45 mm2/year over the next 3 years, and new areas of patchy focal chorioretinal atrophy developed in the perifovea. Conclusions Rapid progression of chorioretinal atrophy was observed in a patient with punctate inner choroiditis. Because punctate inner choroiditis is often associated with degenerative myopia, the retina is fragile and may be susceptible to mechanical damage. This case report alerts clinicians to the need for careful management of patients with punctate inner choroiditis, especially after vitrectomy.

Long-term outcome of internal limiting membrane peeling with and without foveal sparing in myopic foveoschisis

2018 ◽  
Vol 29 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Mohammed Mamdouh Elwan ◽  
Ayman Elsayed Abd Elghafar ◽  
Sherein Mahmoud Hagras ◽  
Waleed Ali Abou Samra ◽  
Sameh Mohamed Saleh
Keyword(s):  
Visual Acuity ◽  
Internal Limiting Membrane ◽  
Foveal Thickness ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Myopic Foveoschisis ◽  
Central Foveal Thickness ◽  
Corrected Visual Acuity ◽  
Significant Difference ◽  
Best Corrected Visual Acuity

Purpose: To compare between vitrectomy with internal limiting membrane peeling over the whole macula and preservation of the epi-foveal internal limiting membrane in myopic foveoschisis. Patients and methods: A prospective controlled non- randomized comparative study included patients with myopic foveoschisis recruited between 2013 and 2017. Patients were allocated into two groups: group A included patients who underwent vitrectomy with complete macular internal limiting membrane peeling and group B included those who underwent preservation of the epi-foveal membrane. Pre- and postoperative best corrected visual acuity and macular optical coherence tomography were obtained and compared. Results: There was no statistically significant difference between the two groups regarding the preoperative baseline data. The difference between the two groups was insignificant as regard postoperative best corrected visual acuity (p = 0.18) and central foveal thickness (p =0.504). There was statistically significant improvement in final best corrected visual acuity within each group (p < 0.0001). Central foveal thickness significantly decreased postoperatively within each group (p < 0.001). No macular holes or other visual-threatening complications were recorded in either group. Conclusion: Vitrectomy with complete internal limiting membrane peeling resulted in comparable outcomes to those achieved with preservation of the epi-foveal membrane in treating cases with myopic foveoschisis. There was no statistically significant difference in final visual acuity between the two groups. No macular holes were recorded in either group.

scholarly journals Vitrectomy for the removal of idiopathic epiretinal membrane with or without internal limiting membrane peeling: a meta-analysis

2020 ◽  
Vol 12 ◽  
pp. 251584142092713 ◽  
Author(s):  
Eleni Christodoulou ◽  
Georgios Batsos ◽  
Petros Galanis ◽  
Christos Kalogeropoulos ◽  
Andreas Katsanos ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Epiretinal Membrane ◽  
Meta Analysis ◽  
Internal Limiting Membrane ◽  
Foveal Thickness ◽  
Epiretinal Membranes ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Central Foveal Thickness ◽  
Corrected Visual Acuity

Purpose: The aim of this study is to analyze the effect of internal limiting membrane peeling in removal of idiopathic epiretinal membranes through meta-analysis. Methods: We searched PubMed for studies published until 30 April 2018. Inclusion criteria included cases of idiopathic epiretinal membranes, treated with vitrectomy with or without internal limiting membrane peeling. Exclusion criteria consisted of coexisting retinal pathologies and use of indocyanine green to stain the internal limiting membrane. Sixteen studies were included in our meta-analysis. We compared the results of surgical removal of epiretinal membrane, with or without internal limiting membrane peeling, in terms of best-corrected visual acuity and anatomical restoration of the macula (central foveal thickness). Studies or subgroups of patients who had indocyanine green used as an internal limiting membrane stain were excluded from the study, due to evidence of its toxicity to the retina. Results: Regarding best-corrected visual acuity levels, the overall mean difference was –0.29 (95% confidence interval: –0.319 to –0.261), while for patients with internal limiting membrane peeling was –0.289 (95% confidence interval: –0.334 to –0.244) and for patients without internal limiting membrane peeling was –0.282 (95% confidence interval: –0.34 to –0.225). Regarding central foveal thickness levels, the overall mean difference was –117.22 (95% confidence interval: –136.70 to –97.74), while for patients with internal limiting membrane peeling was –121.08 (95% confidence interval: –151.12 to –91.03) and for patients without internal limiting membrane peeling was –105.34 (95% confidence interval: –119.47 to –96.21). Conclusion: Vitrectomy for the removal of epiretinal membrane combined with internal limiting membrane peeling is an effective method for the treatment of patients with idiopathic epiretinal membrane.

scholarly journals Kinetic visual acuity is correlated with functional visual acuity at higher speeds

2019 ◽  
Vol 4 (1) ◽  
pp. e000383
Author(s):  
Ikko Iehisa ◽  
Kazuno Negishi ◽  
Masahiko Ayaki ◽  
Kazuo Tsubota
Keyword(s):  
Visual Acuity ◽  
Visual Function ◽  
Linear Mixed Effects Model ◽  
Linear Mixed Effects ◽  
Corrected Visual Acuity ◽  
Registration Number ◽  
Functional Visual Acuity ◽  
The Mean ◽  
All Speeds ◽  
Better Than

ObjectiveTo measure the kinetic visual acuity (KVA) which is the ability to identify approaching objects and the functional visual acuity (FVA) which is continuous VA during 1 min under binocular and monocular condition (non-dominant eye shielding) for healthy subjects, and related ocular parameters to explore their correlation and implication in aspect of integrated visual function.MethodsThe mean age of the 28 participants was 38.6±8.9 years (range, 23–57 years; 6 women). A KVA metre (AS-4Fα) and FVA metre (AS-28) were used to measure KVA and FVA, respectively. Multiple regression analysis was conducted to explore correlations among the measured visual function and related parameters, including age, binocularity, best-corrected visual acuity, refraction and tear break-up time.ResultsThe results of binocular KVA were better than monocular KVA at all speeds. A strong correlation was found between monocular and binocular KVA. The results of binocular FVA were better than monocular FVA (p<0.001) and there was a correlation between monocular and binocular FVA (R=0.638, p<0.001), as well as the maintenance rate for FVA (R=0.228, p=0.003). A linear mixed-effects model revealed that binocularity for KVA prediction was significant at all speeds and FVA was also significant at 60 km/h (p<0.05).ConclusionThe current results suggest that both binocularity and FVA may contribute to KVA.Trial registration numberUMIN00032385

Epiretinal Membrane Peeling in Patients With Good Preoperative Vision

2017 ◽  
Vol 1 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Nicholas D. Chinskey ◽  
Gaurav K. Shah
Keyword(s):  
Visual Acuity ◽  
Epiretinal Membrane ◽  
Chart Review ◽  
Vitreous Hemorrhage ◽  
Retrospective Chart Review ◽  
Corrected Visual Acuity ◽  
Additional Procedure ◽  
Pars Plana ◽  
Baseline Visual Acuity

Objective: To evaluate the outcomes of patients undergoing removal of an epiretinal membrane (ERM) with good starting visual acuity. Design: Retrospective chart review. Participants: Forty eyes of 40 patients seen at a tertiary, referral-based private practice. Methods: All patients undergoing pars plana vitrectomy with removal of an ERM by a single surgeon (G.K.S.) from the years 2012 to 2014 were evaluated. Patients who were phakic, had a baseline visual acuity of 20/50 or worse, and those who had surgery less than 6 months prior to data collection were excluded. Results: Of the 40 patients included, only 2 (5%) developed a serious postoperative complication. One had a vitreous hemorrhage that cleared without further surgical intervention, and another developed a macula on retinal detachment that required 1 additional procedure. Nineteen (47.5%) had improved best-corrected visual acuity (BCVA), 10 (25%) maintained their initial BCVA, 7 (17.5%) lost 1 to 2 lines, and 4 (10%) lost 3 lines or greater at their last follow-up visit. When looking only at idiopathic ERMs in the group, the results were similar with 48% with improved vision, 29% maintained the initial BCVA, 16% lost 1 to 2 lines, and 6% lost 3 lines or greater. Discussion: Surgery to remove an ERM is a reasonable option for those with significant metamorphopsia and highly symptomatic blurring of central vision, even with good baseline visual acuity.

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