J Korean Ophthalmol Soc.  2018 Jan;59(1):23-30. 10.3341/jkos.2018.59.1.23.

Effects of Internal Limiting Membrane Peeling in Combined Hamartoma of Retina and Retinal Pigment Epithelium

• Park JH
• Park JM

• KMID: 2401674
• DOI: http://doi.org/10.3341/jkos.2018.59.1.23

Abstract

PURPOSE
To evaluate the effects of peeling the internal limiting membrane (ILM) of an epiretinal membrane (ERM) for surgical treatment of combined hamartoma of the retina and retinal pigment epithelium (RPE).
METHODS
We retrospectively reviewed the records of 11 patients (11 eyes) with ERM of combined hamartoma of the retina + RPE and 22 patients (22 eyes) with idiopathic ERM who treated with pars plana vitrectomy and removal of the ERM. The patients were divided into four groups: involving eyes with (5 eyes) or without (6 eyes) ILM peeling in combined hamartoma of the retina + RPE group and eyes with (10 eyes) or without (12 eyes) ILM peeling in the idiopathic ERM group. Anatomical outcomes, functional outcomes, complications and recurrences were compared between eyes with and without ILM peeling.
RESULTS
Central retinal thickness (CRT) and subfoveal choroidal thickness (SFCT) decreased and postoperative best-corrected visual acuity (BCVA) improved regardless of ILM peeling in all groups. There were no statistically significant differences in CRT, SFCT and BCVA between without and with ILM peeling in ERM of combined hamartoma of the retina + RPE and idiopathic ERM groups. There were no complications and recurrences in any group.
CONCLUSIONS
The additional ILM peeling did not affect the postoperative results.

Keyword

Central retinal thickness; Combined hamartoma of the retina and retinal pigment epithelium; Epiretinal membrane; Internal limiting membrane peeling; Subfoveal choroidal thickness

MeSH Terms

Choroid
Epiretinal Membrane
Hamartoma*
Humans
Membranes*
Recurrence
Retina*
Retinal Pigment Epithelium*
Retinaldehyde*
Retrospective Studies
Visual Acuity
Vitrectomy
Retinaldehyde

Figure

• 

  Figure 1 Preoperative optical coherence tomography images of combined hamartoma of the retina and retinal pigment epithelium. These images showed the epiretinal membrane of combined hamartoma of the retina and retinal pigment epithelium and distorted fovea contour.

• 

  Figure 2 Epiretinal membrane (ERM) of combined hamartoma of the retina and retinal pigment epithelium in 73 years old man. (A) Preoperative fundus photo showed gray elevated lesion with preretinal gliosis, vascular tortuosity with vascular traction, hyperplasia of retinal pigment epithelium at the margin of growth. Preoperative visual acuity was logMAR 0.5. (B) Preoperative enhanced depth image (EDI) of optical coherence tomography showed folded, distorted retinal thickening with ERM. (C) Preoperative fluorescein angiography showed increasing fluorescence in perimacular area in early phase. (D) Preoperative fluorescein angiography showed hyperfluorescent lesion with blocked fluorescence, vascular distortion with retinal vascular contracting toward the lesion in late phase. (E) Fundus photo at 12 months after membrane peeling, internal limiting membrane peeling, ERM of combined hamartoma of the retina and retinal pigment epithelium was removed. Visual acuity was improved to logMAR 0.1. (F) EDI at 12 months after membrane peeling, internal limiting membrane peeling, central retinal thickness value has decreased 550 µm to 337 µm and subfoveal choroidal thickness value has decreased 203 µm to 191 µm.

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