Purpose: To study the potential association between fundus autofluorescence, spectral-domain optical coherence tomography, and visual acuity in patients undergoing surgery because of epiretinal membranes.
Methods: Prospective, interventional case series including 26 patients submitted to vitrectomy because of symptomatic epiretinal membranes. Preoperative evaluation consisted of a complete ophthalmologic examination, autofluorescence, and spectral-domain optical coherence tomography. Studied variables included foveal autofluorescence (fov.AF), photoreceptor inner segment/outer segment (IS/OS) junction line integrity, external limiting membrane integrity, central foveal thickness, and foveal morphology. All examinations were repeated at the first, third, and sixth postoperative months. The main outcome measures were logarithm of minimal angle resolution visual acuity, fov.AF integrity, and IS/OS integrity.
Results: All cases showing a continuous IS/OS line had an intact fov.AF, whereas patients with IS/OS disruption could have either an increased area of foveal hypoautofluorescence or an intact fov.AF, with the latter being associated with IS/OS integrity recovery in follow-up spectral-domain optical coherence tomography imaging. The only preoperative variables presenting a significant correlation with final visual acuity were baseline visual acuity (P = 0.047) and fov.AF grade (P = 0.023).
Conclusion: Recovery of IS/OS line integrity after surgery, in patients with preoperative IS/OS disruption and normal fov.AF, can be explained by the presence of a functional retinal pigment epithelium–photoreceptor complex, supporting normal photoreceptor activity. Autofluorescence imaging provides a functional component to the study of epiretinal membranes, complementing the structural information obtained with optical coherence tomography.
A prospective, interventional case series investigating the role of fundus autofluorescence as a predictive factor for visual acuity recovery after vitrectomy for removal of epiretinal membranes. Results indicate that autofluorescence provides a valuable physiologic component to the clinical evaluation of patients with epiretinal membranes, which can aid in the correct interpretation of the essentially morphologic information obtained with optical coherence tomography.
*Department of Ophthalmology, Hospital S. João, Alameda Prof. Hernâni Monteiro, Porto, Portugal; and
†Faculty of Medicine of Porto, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal.
Reprint requests: Nuno L. Gomes, MD, Serviço de Oftalmologia, Hospital S. João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; e-mail: firstname.lastname@example.org
None of the authors have any financial/conflicting interests to disclose.