To identify prognostic factors that may predict the amount of long-term visual improvement after idiopathic epiretinal membrane removal.
A retrospective study of 114 patients who underwent epiretinal membrane removal was performed. The central foveal thickness, inner retinal layer thickness, inner retinal irregularity index, length of the cone outer segment tip line defect, and length of the ellipsoid zone defect were measured. The optical coherence tomography parameters that were associated with the amount of visual improvement were determined at 24 months postoperatively.
Central foveal thickness and inner retinal irregularity index were not associated with best-corrected visual acuity at 24 months (P = 0.227 and P = 0.544, respectively), whereas the lengths of cone outer segment tip line defect and ellipsoid zone defect were associated with worse best-corrected visual acuity at 24 months (P = 0.015 and P < 0.001, respectively). Univariate regression analysis indicated that central foveal thickness and inner retinal irregularity index were associated with visual improvement (P = 0.011 and P < 0.001, respectively). Multivariate regression analysis indicated that inner retinal irregularity index, a marker of the inner retinal deformation, was associated with visual improvement after adjusting for age, gender, and other optical coherence tomography findings (P < 0.001).
Patients with preoperative inner retinal deformation were found to have significantly improved long-term visual outcomes after epiretinal membrane removal.
Inner retinal deformation, as measured by the inner retinal irregularity index, was associated with poorer preoperative and early postoperative visual acuity but not with poorer long-term vision, resulting in a net greater visual improvement at 24 months after epiretinal membrane removal. Thus, the preoperative presence of inner retinal deformation appears to be a good prognostic indicator for long-term visual gain after epiretinal membrane surgery.
*Keye Eye Center, Seoul, Korea; and
†Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Reprint requests: Won Ki Lee, MD, PhD, Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea; e-mail: firstname.lastname@example.org
Supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (grant no.: HI17C2012).
None of the authors have any financial/conflicting interests to disclose.