J Korean Ophthalmol Soc.  2014 May;55(5):686-692. 10.3341/jkos.2014.55.5.686.

Surgical Outcomes of Idiopathic Epiretinal Membrane with Good Visual Acuity

• Kim SI
• Park SW
• Byon IS
• Lee JE

• KMID: 2218089
• DOI: http://doi.org/10.3341/jkos.2014.55.5.686

Abstract

PURPOSE
To evaluate surgical outcomes of idiopathic epiretinal membrane (ERM) with good visual acuity.
METHODS
We evaluated patients who were diagnosed with idiopathic ERM with best corrected visual acuity (BCVA) greater than 20/40 and who were followed-up for 12 months or longer after vitrectomy and membrane removal. BCVA, metamorphopsia, central subfield macular thickness (CSMT), foveal contour, and status of photoreceptor inner/outer segment (IS/OS) junction were retrospectively assessed based on the medical records and optical coherence tomography (OCT) images.
RESULTS
Twenty-four eyes were included in the present study. The mean BCVA (log MAR) did not significantly improve from baseline to 12 months after surgery (0.26 +/- 0.06 and 0.25 +/- 0.19, respectively). Six eyes showed improved vision of two or more lines, and six eyes had decreased vision of two or more lines. Metamorphopsia remained in all four eyes with preoperative symptoms until 12 months postoperatively. CSMT decreased significantly from 418 +/- 86 microm at baseline to 343 +/- 45 microm at 12 months (p < 0.01). Among 17 eyes without foveal depression at baseline, 11 eyes recovered a foveal depression at an average of 6.6 months after surgery. IS/OS status at baseline was intact in 19 eyes, attenuated in three eyes, and disrupted in two eyes and did not change significantly at 12 months.
CONCLUSIONS
Surgical treatment for idiopathic ERM with good visual acuity resulted in anatomical but not functional improvement. Choosing surgery for idiopathic ERM with good visual acuity should be considered carefully because decreased visual acuity could result in some patients.

Keyword

Good visual acuity; Idiopathic epiretinal membrane; Inner limiting membrane; Removal of membrane; Vitrectomy

MeSH Terms

Depression
Epiretinal Membrane*
Humans
Medical Records
Membranes
Retrospective Studies
Tomography, Optical Coherence
Vision Disorders
Visual Acuity*
Vitrectomy

Figure

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  Figure 1. Classification of the inner segment/outer segment (IS/OS) junction of the photoreceptor layer according to optical coherence tomography scan. (A) Intact type; continuous hyper-reflectivity line of the IS/OS junction. (B) Attenuated type; decreased reflectivity line of the IS/OS junction. (C) Disrupted type; absent or discontinuity of the IS/OS junction.

• 

  Figure 2. Changes in central subfield macular thickness (CSMT) and the best corrected visual acuity (BCVA). Values are presented as mean ? SD. CSMT improved significantly 1 month after surgery (*p < 0.01), but BCVA did not.

• 

  Figure 3. Optical coherence tomography images of the fovea. (A) Of 17 eyes without foveal depression at baseline, (B) 11 eyes had a foveal depression after 6.6 months in average.

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