Correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling in idiopathic macular epiretinal membrane eyes_Chinese Journal of Ocular Fundus Diseases

Authors：

 Zeng Miao , Chen Xiao , Hong Ling , Yan Yin , Huang Zhijian

Wuhan General Hospital of Chinese People’s Liberation Army，Wuhan 430070，China;

Corresponding author：

Zeng Miao, Email: zengmiao1982@163.com

Keywords：

Macula lutea; Membranes; Vitrectomy; Tomography, optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2017.04.012

Video：

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Objective To analyze the correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling (ILMP) in idiopathic macular epiretinal membrane (IMEM) eyes. Methods This is a retrospective case series of 47 IMEM patients (49 eyes). All the patients underwent 25G pars plana vitrectomy with IMEM removal and ILMP. The best corrected visual acuity (BCVA) was measured using the international standard visual acuity chart, and the results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity. The severity of metamorphopsia was measured using M-charts. The central macular thickness (CMT), inner nuclear layer thickness (INT), inner retinal layer thickness (IRT), outer retinal layer thickness (ORT), the status of ellipsoid zone (EZ) were assessed with spectral-domain optical coherence tomography at baseline and each month postoperatively. The differences in BCVA, CMT, INT, IRT, ORT and status of EZ before and after surgery were analyzed, so did the correlations between these indexes at the same time. Results Compared with baseline, the postoperative BCVA was significantly increased (F=6.133, P＜0.001), but the M value, CMT, INT, IRT, ORT were significantly decreased (F=12.481, 10.565, 15.739, 6.046, 10.569; P＜0.001);the integrity of EZ was improved significantly (χ²=12.309, P＜0.001). Preoperative BCVA was positively related to the CMT (r=0.720) and ORT (r=0.720, 0.887; P＜0.05), while negatively related to preoperative integrity of EZ (r=−0.295, P＜0.05). The postoperative BCVA was positively related to the preoperative BCVA and postoperative CMT, ORT (r=0.774, 0.754, 0.842; P＜0.05), while negatively related to postoperative integrity of EZ (r=−0.676, P＜0.05). The preoperative M value was positively related to the preoperative CMT, INT, IRT, and ORT (r=0.931, 0.668, 0.840, 0.637; P＜0.05). The postoperative M value was positively related to the preoperative M value and postoperative CMT, INT, IRT, and ORT (r=0.723, 0.722, 0.767, 0.825, 0.387; P＜0.05). Conclusions Vitrectomy with ILMP for IMEM can improve the visual acuity, metamorphopsia and foveal morphology. Both visual acuity and metamorphopsia correlate with foveal morphology.

Citation： Zeng Miao, Chen Xiao, Hong Ling, Yan Yin, Huang Zhijian. Correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling in idiopathic macular epiretinal membrane eyes. Chinese Journal of Ocular Fundus Diseases, 2017, 33(4): 378-382. doi: 10.3760/cma.j.issn.1005-1015.2017.04.012 Copy

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2.	Dawson SR, Shunmugam M, Williamson TH. Visual acuity outcomes following surgery for idiopathic epiretinal membrane: an analysis of data from 2001 to 2011[J]. Eye (Lond), 2014, 28(2): 219-224. DOI: 10.1038/eye.2013.253.
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10.	Jackson TL, Nicod E, Angelis A, et al. Pars plana vitrectomy for vitreomacular traction syndrome: a systematic review and metaanalysis of safety and efficacy[J]. Retina, 2013, 33(10): 2012-2017. DOI: 10.1097/IAE.0b013e3182a6b3e2.
11.	Bae SH, Kim D, Park TK, et al. Preferential hyperacuity perimeter and prognostic factors for metamorphopsia after idiopathic epiretinal membrane surgery[J]. Am J Ophthalmol, 2013, 155(1): 109-117. DOI: org/10.1016/j.ajo.2012.07.007.
12.	Kim J, Rhee KM, Woo SJ, et al. Long-term temporal changes of macular thickness and visual outcome after vitrectomy for idiopathic epiretinal membrane[J]. Am J Ophthalmol, 2010, 150(5): 701-709. DOI: org/10.1016/j.ajo.2010.05.037.
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14.	Bouwens MD, de Jong F, Mulder P, et al. Results of macular pucker surgery: 1- and 5-year follow-up[J]. Graefe’s Arch Clin Exp Ophthalmol, 2008, 246(12): 1693-1697. DOI: org/10.1007/s00417-008-0909-1.
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1. Bu SC, Kuijer R, Li XR, et al. Idiopathic epiretinal membrane[J]. Retina, 2014, 34(12): 2317-2335. DOI: 10.1097/IAE.0000000000000349.
2. Dawson SR, Shunmugam M, Williamson TH. Visual acuity outcomes following surgery for idiopathic epiretinal membrane: an analysis of data from 2001 to 2011[J]. Eye (Lond), 2014, 28(2): 219-224. DOI: 10.1038/eye.2013.253.
3. Wong JG, Sachdev N, Beaumont PE, et al. Visual outcomes following vitrectomy and peeling of epiretinal membrane[J]. Clin Experiment Ophthalmol, 2005, 33(4): 373-378.
4. Kunikata H, Abe T, Kinukawa J, et al. Preoperative factors predictive of postoperative decimal visual acuity ≥1.0 following surgical treatment for idiopathic epiretinal membrane[J]. Clin Ophthalmol, 2011, 5: 147-154. DOI: 10.2147/OPTH.S15848.
5. Kinoshita T, Kovacs KD, Wagley S, et al. Morphologic differences in epiretinal membranes on ocular coherence tomography as a predictive factor for surgical outcome[J]. Retina, 2011, 31(8): 1692-1698. DOI: 10.1097/IAE.0b013e31820f49d0.
6. Rii T, Itoh Y, Inoue M, et al. Outer retinal morphological changes and visual function after removal of epiretinal membrane[J]. Can J Ophthalmol, 2014, 49(5): 436-442. DOI: 10.1016/j.jcjo.2014.06.007.
7. Matsumoto C, Arimura E, Okuyama S, et al. Quantification of metamorphopsia in patients with epiretinal membranes[J]. Invest Ophthalmol Vis Sci, 2003, 44(9): 4012-4016. DOI: org/10.1167/iovs.03-0117.
8. Pournaras CJ, Donati G, Brazilikos PD, el al. Macular epiretinal membranes[J]. Semin Ophthalmol, 2000, 15(2): 100-107. DOI: 10.1053/soph.2000.7207.
9. 王泓, 张平, 陈凤娥, 等. 23G玻璃体切割手术联合与不联合内界膜剥除治疗特发性黄半年前膜的疗效对比观察[J]. 中华眼底病杂志, 2014, 30(4): 361-365. DOI: 10.3760/cma.j.issn.1005-1015.2014.04.007.Wang H, Zhang P, Chen FE, et al. Clinical outcomes of idiopathic macular epiretinal membrane removal by 23G vitrectomy with or without internal limiting membrane peeling[J]. Chin J Ocul Fundus Dis, 2014, 30(4): 361-365. DOI: 10.3760/cma.j.issn.1005-1015.2014.04.007.
10. Jackson TL, Nicod E, Angelis A, et al. Pars plana vitrectomy for vitreomacular traction syndrome: a systematic review and metaanalysis of safety and efficacy[J]. Retina, 2013, 33(10): 2012-2017. DOI: 10.1097/IAE.0b013e3182a6b3e2.
11. Bae SH, Kim D, Park TK, et al. Preferential hyperacuity perimeter and prognostic factors for metamorphopsia after idiopathic epiretinal membrane surgery[J]. Am J Ophthalmol, 2013, 155(1): 109-117. DOI: org/10.1016/j.ajo.2012.07.007.
12. Kim J, Rhee KM, Woo SJ, et al. Long-term temporal changes of macular thickness and visual outcome after vitrectomy for idiopathic epiretinal membrane[J]. Am J Ophthalmol, 2010, 150(5): 701-709. DOI: org/10.1016/j.ajo.2010.05.037.
13. Murakami T, Okamoto F, Iida M, et al. Relationship between metamorphopsia and foveal microstructure in patients with branch retinal vein occlusion and cystoid macular edema[J]. Graefe’s Arch Clin Exp Ophthalmol, 2016, 254(11): 2191-2196. DOI: org/10.1007/s00417-016-3382-2.
14. Bouwens MD, de Jong F, Mulder P, et al. Results of macular pucker surgery: 1- and 5-year follow-up[J]. Graefe’s Arch Clin Exp Ophthalmol, 2008, 246(12): 1693-1697. DOI: org/10.1007/s00417-008-0909-1.
15. Okamoto F, Sugiura Y, Okamoto Y, et al. Inner nuclear layer thickness as a prognostic factor for metamorphopsia after epiretinal membrane surgery[J]. Retina, 2015, 35(10): 2107-2114. DOI: 10.1097/IAE.0000000000000602.

Chinese Journal of Ocular Fundus Diseases

Correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling in idiopathic macular epiretinal membrane eyes

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