Meléndez-Ledesma MSE, Romo-García E, Godina-Morales JA, Santoyo-Gómez EJ, Miranda-Haro SC, Mora-Palazuelos CE

Language: Spanish
References: 11
Page: 23-33
PDF size: 451.55 Kb.

ABSTRACT

Objective: To analyse the microvascular changes in the macula with OCTA six months after surgery in patients thar underwent surgery for ERM. Methods: This is a observational, descriptive, longitudinal, retrospective study in which we review the records of patients with ERM that underwent PPV with peeling of ERM and MLI al least 6 months before the study. OCTA was performed to analyse FAZ, foveal and parafoveal vascular density. Classification of the severity of ERM and BCVA before and after the surgery was noted. Results: 34 patients (34 eyes) were studied. 4 eyes with ERM grade 2, 15 eyes with ERM grade 3 and 15 eyes with ERM grade 4. Preoperatory BCVA was 0.91 ± 0.29 and mean CMT was 453.09 ± 73.28. Final BCVA was 0.51 ± 0.31 and mean CMT was 324.35 ± 56.05. FAZ measured with OCTA had a mean area of 0.22 ± 0.12mm, mean perimeter 2.35 ± 0.65 and mean circularity of 0.37 ± 0.08. BCVA had a high positive correlation (p= 0.000) with FVD in the SCP and DCP. On the other hand, there was a medium to high negative correlation (p= 0.004) with FAZ circularity, perimeter and area. Conclusions: There are microvascular changes in eyes with ERM, which are a higher foveal perfusion density and a smaller FAZ. This changes correlate with worse visual outcomes.

REFERENCES

1. Fraser-Bell S, Guzowski M, Rochtchina E, Wang J, Mitchell P. Five-year cumulative in-cidence and progression of epiretinal mem-branes: the Blue Mountains Eye Study. Op-hthalmol 2003;110(1):34-40.

2. Machado LM, Furlani BA, Navarro RM, Fa-rah ME, Maia A, Magalhães O, et al. Preope-rative and intraoperative prognostic factors of epiretinal membranes using chromovitrec-tomy and internal limiting membrane pee-ling. Ophthalmic Surg Lasers Imaging Re-tina. 2015 Apr;46(4):457-62.

3. Fung AT, Galvin J, Tran T. Epiretinal mem-brane: A review. Clin Exp Ophthalmol. 2021 Apr;49(3):289-308.

4. Chang WC, Lin C, Lee CH, Sung TL, Tung TH, Liu JH. Vitrectomy with or without inter-nal limiting membrane peeling for idiopathic epiretinal membrane: A meta-analysis. PLoS One. 2017 Jun 16;12(6):e0179105.

5. Kashani AH, Chen CL, Gahm JK, Zheng F, Richter GM, et al. Optical coherence tomo-graphy angiography: A comprehensive re-view of current methods and clinical applica-tions. Prog Retin Eye Res. 2017 Sep;60:66-100.

6. Baba T, Kakisu M, Nizawa T, Oshitari T, Ya-mamoto S. Study of foveal avascular zone by OCTA before and after idiopathic epireti-nal membrane removal. Spektrum der Au-genheilkunde 2018;32(4):31–38.

7. Mao J, Xu Z, Lao J, Chen Y, Xu X, et al. As-sessment of macular microvasculature features before and after vitrectomy in the idiopathic macular epiretinal membrane using a grading system: An optical cohe-rence tomography angiography study. Acta Ophthalmol. 2021 Nov;99(7):e1168-e1175.

8. Govetto A, Lalane RA 3rd, Sarraf D, Figue-roa MS, Hubschman JP. Insights Into Epire-tinal Membranes: Presence of Ectopic Inner Foveal Layers and a New Optical Coherence Tomography Staging Scheme. Am J Op-hthalmol. 2017 Mar;175:99-113.

9. Chen H, Chi W, Cai X, Deng Y, Jiang X. Ma-cular microvasculature features before and after vitrectomy in idiopathic macular epireti-nal membrane: an OCT angiography analysis. Eye 2019;33(4):619–628.

10. Kim GH, Hwang BE, Chun H, Kim JY, Kim RY, Kim M, et al. Morphologic analysis of the foveal avascular zone for prediction of post-operative visual acuity in advanced idiopat-hic epiretinal membrane. Sci Rep. 2023 Jun 27;13(1):10400.

11. Kitagawa Y, Shimada H, Shinojima A, Nakashizuka H. Foveal avascular zone area analysis using optical coherence tomo-graphy angiography before and after idiopa-thic epiretinal membrane surgery. Retina. 2019 Feb;39(2):339-346.