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The present study aimed to assess the feasibility and safety of 27G core-pars plana vitrectomy (PPV) for idiopathic epiretinal membrane (IERM). A retrospective analysis was performed on 38 eyes from 38 patients with IERM with a mean age of 62.73±5.61 years. 27G core-PPV was combined with IERM and internal limiting membrane (ILM) peeling. Pre-operative and post-operative best-corrected visual acuity (BCVA) and lens density were measured. Optical coherence tomography (OCT) and OCT angiography were performed to determine the patients' macular area. Ultrasound biomicroscopy and B-mode ultrasound were subsequently performed to observe any complications and the follow-up period ranged from 1 week to 12 months post-operatively. A total of 36 patients achieved visual improvement of ≥2 Snellen lines, of which 33 patients exhibited improvements within 1 week and the lens density remained unchanged. The mean central macular thickness significantly decreased at 12 months post-operatively (P≤0.05); however, it was not observed to be correlated with BCVA (r=0.41; P>0.05). The foveal avascular zone of the affected eye was significantly smaller than that of the healthy fellow eye (P≤0.05) and negatively correlated with post-operative BCVA (r=-0.72; P≤0.05). Superficial retinal capillary density and deep retinal capillary density decreased post-operatively (both P≤0.05) and no complications were observed. Taken together, the results of the present study indicate that application of 27G core-PPV with ILM peeling is minimally invasive for IERM and facilitates rapid post-operative BCVA recovery. [ABSTRACT FROM AUTHOR]

Background: The epiretinal membrane (ERM) is a degenerative condition associated with age, which can cause loss of vision and/or metamorphopsia. The treatment of symptomatic ERM involves surgical removal including a vitrectomy followed by peeling of the ERM using a microforceps. As the internal limiting membrane (ILM) is adherent to the ERM, it is sometimes removed with it (spontaneous peeling). If ILM remains in place, it can be removed to reduce ERM recurrence. However, it is important to clarify the safety of ILM peeling, while it increases surgical risks and cause histological disorganization of the retina that can lead to microscotomas, may be responsible for definitive visual discomfort.Methods: PEELING is a prospective, randomized, controlled, single-blind, and multicentered trial with two parallel arms. This study investigates the benefit/risk ratio of active ILM peeling among individuals undergoing ERM surgery without spontaneous ILM peeling. Randomization is done in the operating room after ERM removal if ILM remains in place. After randomization, the two groups-"active peeling of the ILM" and "no peeling of the ILM"-are compared during a total of three follow-up visits scheduled at month 1, month 6, and month 12. Primary endpoint is the difference in microscotomas before surgery and 6 months after surgery. Patients with spontaneous peeling are not randomized and are included in the ancillary study with the same follow-up visits and the same examinations as the principal study. Relevant inclusion criteria involve individuals aged > 18 years living with idiopathic symptomatic ERM, including pseudophakic patients with transparent posterior capsule or open capsule or lensed patients with age-related cataracts. The calculated sample size corresponds to 53 randomized eyes (one eye/patient) per arm that means 106 randomized eyes (106 randomized patients) in total and a maximum of 222 included patients (116 spontaneous peeling).Discussion: ILM peeling is often practiced in ERM surgery to reduce ERM recurrence. It does not impair postoperative visual acuity, but it increases the surgical risks and causes anatomical damages. If active ILM peeling is significantly associated with more microscotomas, it may contraindicate the ILM peeling during primitive idiopathic ERM surgery.Trial Registration: ClinicalTrials.gov, NCT02146144. Registered on 22 May 2014. Recruitment is still ongoing. [ABSTRACT FROM AUTHOR]

Purpose: To report anatomic and logMAR best-corrected visual acuity (BCVA) outcomes with long-term follow-up after pars-plana vitrectomy and epiretinal membrane peeling (PPV-MP). Design: A retrospective case-series. Participants: Patients with epiretinal membrane (ERM) who underwent PPV-MP performed by one surgeon. Methods: Best-corrected visual acuity (BCVA) was recorded as a logMAR preoperatively and, when available, at 1, 2, 3, 5, 8, 10 years after surgery. The integrity of outer retinal layers was evaluated using spectral domain optical coherence tomography (SD-OCT). Main Outcome Measures: Postoperative BCVA at different follow-up visits and its correlation with different OCT parameters. Results: Fifty-five eyes of 49 patients were followed postoperatively with a mean of 8.6± 2.6 years (median: 9 years, range 5– 16 years). The mean BCVA improved from 0.56± 0.29 (20/72) preoperatively to 0.33± 0.25 (20/42) at 1 year, 0.29± 0.27 (20/38) at 2 years, 0.25± 0.28 (20/35) at 3 years, 0.29± 0.32 (20/38) at 5 years, 0.28± 0.31 (20/38) at 8 years, and  0.28± 0.25 (20/38) at 10 years (p< 0.001). The BCVA improved at each of the first 3 years postoperatively and remained stable at 5, 8, and 10 years. Postoperative improvement in the integrity of ELM, and EZ, on SD-OCT correlated with improved BCVA. Conclusion: BCVA continues to improve after PPV-MP during the first 3 years postoperatively and remains stable. Improved anatomic integrity of outer retinal layers correlated with improved BCVA. [ABSTRACT FROM AUTHOR]

Abstract Background This study compared the postoperative outcomes of 27-gauge (G) and 25-G vitrectomy performed for the treatment of idiopathic epiretinal membrane (ERM). Methods The study design was single center, retrospective, interventional case series. Two hundred consecutive eyes that underwent primary vitrectomy for ERM (27-G vitrectomy in 100 eyes and 25-G vitrectomy in 100 eyes) were studied for 6 months. In all eyes, scleral tunnels were made using angle incisions, and air or gas exchange was performed. Results There were no significant differences in age, spherical diopter power, as well as preoperative Early Treatment Diabetic Retinopathy Study (ETDRS) score, central retinal thickness (CRT), and intraocular pressure between the 27-G and 25-G groups. The proportions of simultaneous cataract surgery (27-G vs. 25-G: 82% vs. 90%), air-filled eyes (99% vs. 98%), and scleral wound suture at the end of surgery (0% vs. 0%) were not significantly different between two groups. The mean operation time for vitrectomy was significantly (P = 0.0322) longer by 4 min for 27-G (37 min) compared to 25-G (33 min) vitrectomy. Gain in ETDRS score was significantly (P = 0.0421) better in 27-G group (4.7 ± 8.1 letters) compared to 25-G group (1.1 ± 13.6 letters) at 1 month post-vitrectomy, but not significantly different at 3 and 6 months (P = 0.0835 and 0.0569, respectively). Decrease in CRT was significantly (P = 0.0354) greater in 27-G group (−24.2 ± 50.0 μm) compared to 25-G group (−8.0 ± 48.6 μm) at 1 month post-vitrectomy, but not significantly different at 3 and 6 months (P = 0.6059 and 0.1725, respectively). On postoperative day 1, hypotony (≤ 6 mmHg) was observed in 2 eyes in 27-G group and 6 eyes in 25-G group, while ocular hypertension (≥ 25 mmHg) was found in 4 eyes in 27-G group and 11 eyes in 25-G group, with no significant differences between two groups. Postoperative complications requiring treatment occurred in one eye (vitreous hemorrhage) in 27-G group, and in two eyes (vitreous hemorrhage and retinal detachment in one eye each) in 25-G group. Conclusions Although 27-G vitrectomy requires operation time of 4 min longer compared to 25-G vitrectomy for ERM surgery, using the 27-G system results in earlier recovery of visual acuity, CRT improvement and stabilized ocular pressure.

Objective: Comparative morphological characteristic and evaluation of cytokine profile of idiopathic epiretinal membrane (ERM), complicated lamellar macular hole. Materials and Methods: Immunohistochemical study of 15 ERM removed during vitrectomy included the definition of responses to antigens fibronectin, laminin, glial fibrillary acidic protein. All membrane samples were divided into two groups: I group consisted of 8 ERM, which wasn’t clinically combined with retina defects, the II group included 7 ERM complicated lamellar macular hole. Results: ERM in group I were a collagen-membrane with a thickness from 2,1±0,7 to 4,4±1,4 µm, infiltrated radial glial cells, isolated fibroblastic cells. For membranes was characterized by a positive reaction to GFAP and largely negative reaction (62.7%) on fibronectin, laminin. ERM in group II were more thick, which was in the range from 6,03±1,6 to 7.56±1,02 µm, high cell density: radial glial cells, cells of fibroblast series (fibroblasts laminocity, myofibroblasts) and hyalocity. Immunohistochemistry complicated ERM had a positive immunophenotyping antigens against adhesion protein fibronectin, laminin, of GFAP along with a pronounced fibroblastic and macrophage infiltration. Conclusion: ERM complicated lamellar macular hole, characterized by an increased thickness, marked infiltration of radial glial cells, cells of fibroblast series (fibroblasts laminocity, myofibroblasts) and hyalocity. The positive response comparable ERM complicated lamellar macular hole on fibronectin, laminin and GFAP could mean cytokines involved into development and progression of neurodegenerative process. The accumulation of collagen fibers and myofibroblasts may help to strengthen the contractions and reduce the elastic properties of ERM, with the subsequent development of the tangential tractions and retinal tear.Objective: Comparative morphological characteristic and evaluation of cytokine profile of idiopathic epiretinal membrane (ERM), complicated lamellar macular hole. Materials and Methods: Immunohistochemical study of 15 ERM removed during vitrectomy included the definition of responses to antigens fibronectin, laminin, glial fibrillary acidic protein. All membrane samples were divided into two groups: I group consisted of 8 ERM, which wasn’t clinically combined with retina defects, the II group included 7 ERM complicated lamellar macular hole. Results: ERM in group I were a collagen-membrane with a thickness from 2,1±0,7 to 4,4±1,4 µm, infiltrated radial glial cells, isolated fibroblastic cells. For membranes was characterized by a positive reaction to GFAP and largely negative reaction (62.7%) on fibronectin, laminin. ERM in group II were more thick, which was in the range from 6,03±1,6 to 7.56±1,02 µm, high cell density: radial glial cells, cells of fibroblast series (fibroblasts laminocity, myofibroblasts) and hyalocity. Immunohistochemistry complicated ERM had a positive immunophenotyping antigens against adhesion protein fibronectin, laminin, of GFAP along with a pronounced fibroblastic and macrophage infiltration. Conclusion: ERM complicated lamellar macular hole, characterized by an increased thickness, marked infiltration of radial glial cells, cells of fibroblast series (fibroblasts laminocity, myofibroblasts) and hyalocity. The positive response comparable ERM complicated lamellar macular hole on fibronectin, laminin and GFAP could mean cytokines involved into development and progression of neurodegenerative process. The accumulation of collagen fibers and myofibroblasts may help to strengthen the contractions and reduce the elastic properties of ERM, with the subsequent development of the tangential tractions and retinal tear.

AIM: To evaluate two structural predictors of visual outcome of epiretinal membrane surgery. METHODS: Retrospective study for 30 eyes of epiretinal membrane surgery between January 2014 and October 2016. We assessed the related parameters of the optical coherence tomography and recorded the best-corrected visual acuity(BCVA)at baseline and 1, 3 and 6mo after surgery. Correlations between the final best-corrected visual acuity and photoreceptor integrity status or photoreceptor outer segment length were investigated. RESULTS: Average best-corrected visual acuity decreased at 1mo postoperatively compared with baseline, but improved at 3 and 6mo. Central macular were more sweller at 1mo postoperatively than baseline, but a significant thickeness reduction was found at 6mo(PPP=0.023, 0.004). CONCLUSION: Photoreceptor integrity and photoreceptor outer segment length detected by OCT were significant predictors of the final best-corrected visual acuity(BCVA)after idiopathic epiretinal membrane surgery.

Background: Idiopathic epiretinal membrane (iERM) is a common disorder of the vitreomacular interface characterized by decreased visual acuity and metamorphopsia. This study aimed to analyze the association between the anatomical change of the retina and functional outcomes in iERM patients so as to derive the prognostic factors of visual acuity (VA) and metamorphopsia., Methods: Forty-five patients (one eye per patient; 45 eyes in total) who underwent pars plana vitrectomy and membrane peeling for iERM by a single surgeon were enrolled in this retrospective study. The results on best-corrected visual acuity (BCVA) and metamorphopsia as well as retinal images were obtained before the surgery and 1, 3, 6 months after the surgery. The BCVA and retinal microstructure, including central retinal thickness (CRT), ganglion cell layer (GCL) thickness, inner nuclear layer (INL) and outer nuclear layer + outer plexiform layer (ONL+OPL), and continuity of photoreceptor inner/outer segment (IS/OS) junction before and after iERM surgery were compared using paired samples t -test (continuous variables) or Chi-square test (categorical variables). Multiple regression analysis was carried out to explore the association among BCVA, M-score, and the parameters derived from optical coherence tomography., Results: Compared with preoperative data, a significant improvement in BCVA was observed 1, 3, and 6 months postoperatively (t = 5.37, p < 0.0001; t = 7.29, p < 0.0001; t = 6.44, p < 0.0001 for 1, 3, and 6 months postoperatively, respectively), whereas the M-score only decreased significantly 3 and 6 months after the surgery (t = 2.36, p = 0.02; t = 5.00, p < 0.0001, respectively). In comparison with the baseline, the CRT, INL, and ONL+OPL thickness showed a significant decrease at each postoperative follow-up time, and GCL thickness (t = 3.86, p = 0.0002) and IS/OS disruption ratio (χ 2 = 4.86, p = 0.027) were markedly reduced only 6 months postoperatively. Six-month postoperative BCVA was considerably associated with preoperative CRT and ONL+OPL thickness, as well as postoperative CRT, ONL+OPL thickness, and severity of IS/OS disruption. Moreover, the M-score after surgery was markedly correlated with both the preoperative and postoperative INL and CRT thickness., Conclusions: Both VA and M-score in iERM patients were significantly improved after vitrectomy. Pre- and post-operative CRT was significantly associated with both postoperative BCVA and M-score. Besides, pre- and post-operative INL thickness was correlated to postoperative metamorphopsia, and postoperative BCVA was associated with postoperative ONL+OPL thickness and IS/OS integrity.

Purpose. To evaluate an efficacy of micropulse laser exposure (MPLE) for the treatment of macular edema after surgical removal of idiopathic epiretinal membrane (iERM) using a 577nm laser wavelength.Material and methods. The study involved 99 patients (99 eyes) with macular edema after microinvasive endovitreal surgery with the removal of epiretinal and internal limiting membranes. Patients were divided into 2 groups: basic and control. Patients of the main group underwent the MPLE using the 577nm wavelength 2 weeks after the endovitreal intervention. In the control group the patients were followed without laser and conservative treatment.Results. In the study group an increase of the visual acuity was noted in the follow-up period up to 9 months, thereafter a stabilization of results was at the level of 0.7 [0.5; 0.8], a less progressive improvement of visual acuity reaching a level of 0.5 [0.2; 0.6] (p

Purpose: To assess the levels of neutrophil-to-lymphocyte ratio (NLR) in patients with idiopathic epiretinal membrane (iERM) and to compare the NLR results of patients with iERM and healthy controls.Methods: This retrospective study enrolled 43 patients with iERM and 40 healthy subjects. Complete ophthalmologic examination and complete blood count measurements were performed of all subjects. Complete blood counts were performed within 2 h of blood collection.Results: There was a significant difference in NLR between iERM and control groups (p < 0.01). The receiver operating characteristics analysis revealed that the value of NLR to distinguish patients with iERM and controls was found to be 0.832. The best cutoff value was 1.90, with a sensitivity of 72% and specificity 70%.Conclusions: Our study for the first time provides evidence that subclinical systemic inflammation may cause or at least accompanies iERM using a novel biomarker NLR. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine the size of the foveal avascular zone (FAZ) by optical coherence tomography angiography (OCTA) after surgery for an idiopathic epiretinal membrane (ERM).Methods: This study comprised a retrospective, observational case series. In all, 17 eyes of 17 patients with an idiopathic ERM were studied. Pars plana vitrectomy was performed with internal limiting membrane (ILM) peeling. The area of the superficial FAZ and the central macular thickness were determined by OCTA. Retinal sensitivity was measured by microperimetry.Results: The size of the preoperative FAZ was difficult to determine because of the poor images of the capillary network. The size of the FAZ was smaller than that of the control eyes at all time points (p < 0.001). There was a significant inverse correlation between the area of the postoperative FAZ and the CMT (r = −0.480, p = 0.048 at 3 months; r = −0.565, p = 0.018 at 6 months; r = −0.534, p = 0.027 at 12 months), and between the area of the FAZ and retinal sensitivity (r = −0.622, p = 0.008 at 3 months; r = −0.578, p = 0.015 at 6 months), postoperatively.Conclusion: The significantly small FAZ after ERM surgery indicates a macular deformity caused by a contraction of the ERM. This change persisted for at least 12 months after the surgery. [ABSTRACT FROM AUTHOR]

Purpose: LR11 (also called SorLA or SORL1) is a migration regulator of adherent cells with the immature proliferative phenotype. The present study investigated the clinical and pathological involvement of the soluble form of LR11 (sLR11) in the idiopathic epiretinal membrane (iERM). Methods: The subjects were 51 patients with iERM (24 cellophane macular reflex (CMR) and 27 preretinal macular fibrosis (PMF)) and 45 patients with macular holes as age and sex-matched controls. Vitreous sLR11 and transforming growth factor (TGF)β2 levels were measured by ELISA. Results: The sLR11 levels in the vitreous fluids of patients with iERM (20.2 ± 8.1 ng/mL) were significantly higher than those in controls (11.4 ± 4.7 ng/mL). Among the patients with iERM, the vitreous sLR11 levels were significantly higher in PMF (23.6 ± 8.2 ng/mL), than those in CMR (16.5 ± 5.9 ng/mL). Multivariate regression analysis of the studied factors showed that sLR11 was a unique factor independently contributing to the discrimination of the iERM patients against the control subjects (odds ratio [OR] 1.35 per 1-ng/mL increase, 95% CI 1.09-1.67; P = 0.004). ROC analysis showed that the sensitivity and the specificity of sLR11, but not of other studied factors, categorized into the rank of moderate accuracy. Finally, there was a positive correlation (R = 0.588; P = 0.003) between the vitreous levels of sLR11 and TGFβ2 using the available samples. Conclusions: sLR11 levels in vitreous fluids were specifically increased in patients with iERM, suggesting the involvement in the pathology of proliferative and migrating cells for the development of iERM. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate choroidal thickness modifications before and after vitrectomy with or without phacoemulsification for idiopathic epiretinal membrane in the operated eye and in the unaffected fellow eye. Methods: In total, 53 eyes of 53 patients underwent 25-gauge pars plana vitrectomy plus internal limiting membrane peeling and air tamponade. Twenty-seven eyes underwent combined surgery with phacoemulsification and intraocular lens implantation. Choroidal thickness was measured using enhanced deep image spectral-domain optical coherence tomography at the fovea and at 500 and 2,500 µm from the fovea. Fellow eyes without any previous ocular surgery history served as controls. Results: Baseline comparison did not show significant differences between study and fellow eyes (p > 0.05). Choroidal thickness significantly decreased in the subfoveal area (p = 0.004) as well as at 500 µm (p = 0.026) and 2,500 µm nasally (p = 0.019) and at 500 µm (p = 0.039) and 2,500 µm (p = 0.005) temporally to the fovea. No significant changes were observed postoperatively in the superior and inferior areas (p > 0.05). No differences were found between eyes which underwent combined surgery and those which underwent vitrectomy alone (p > 0.05). The unaffected eyes did not show any significant changes (p > 0.05). Conclusions: Comparison of baseline values did not show any differences between affected and unaffected eyes, meaning that choroidal thickness was not influenced by the development of epiretinal membrane. Vitrectomy plus epiretinal and inner limiting membrane removal may influence choroidal homeostasis, leading to a decrease in choroidal thickness in the subfoveal, nasal, and temporal areas. Combined surgery did not show significant differences when compared to vitrectomy alone. [ABSTRACT FROM AUTHOR]

• Epiretinal membrane is vitreoretinal interface disease that cause to decrease of vision acuity. • The first study in which a large number of patients many current categorical and numerical of optical coherens tomography parameters were evaluated together. • Presence of disorganization of the inner retinal layers is associated with lower visual acuity in patients with idiopathic epiretinal membrane. This study aimed to determine the relationship between basal visual acuity (VA) and basal optical coherence tomography (OCT) parameters of patients with idiopathic epiretinal membrane (iERM). The study included 200 eyes of 200 patients with iERM. In the evaluation of basal VAs, logMAR 0.3 (0.5 on Snellen chart) was accepted as the limit, and the patients were divided into two groups as Group 1 with VA values below logMAR 0.3 and Group 2 with those above logMAR 0.3. Using OCT, the ellipsoid zone (EZ), interdigitation zone (IZ), external limiting membrane (ELM) integrity, peaked appearance of EZ in the fovea, disorganization of the inner retinal layers (DRIL), central foveal thickness (CFT), maximum retinal thickness (MRT), total photoreceptor length (TPL), photoreceptor outer segment length (PROSL), photoreceptor deformity index (PDI), and inner retinal layer irregularity index (IRLII) were evaluated and compared between the groups. There were an equal number of patients in Group 1 and Group 2. The preservation of ELM, EZ, and IZ integrity and the peaked appearance of EZ in the fovea were observed at higher rates in Group 1, whereas the rate of DRIL was higher in Group 2 (p < 0.05 for all). In the multiple regression analysis performed to evaluate categorical OCT parameters, only the presence of DRIL was found to be significantly associated with VA (p < 0.003). CFT*, MRT*, and IRLII** were significantly lower in Group 1 (* p < 0.001, ** p = 0.001). TPU, PROSL, and FDI were similar between the two groups (p > 0.05 for all). According to the multiple regression analysis, only the presence of DRIL was correlated with lower VA values. Among the OCT parameters, an increase in CFT and MRT, as well as the IRLII value moving away from 1 were related to lower VA values. [ABSTRACT FROM AUTHOR]

Purpose: To explore the surgical outcomes of the macular microvasculature and visual function in eyes with idiopathic epiretinal membrane (iERM) using spectral-domain optical coherence tomography angiography (SD-OCTA). Methods: This observational, cross-sectional study included 41 participants who underwent iERM surgery with a 3-month (3M) follow-up. Forty-one healthy eyes formed the control group. The assessments included best-corrected visual acuity (BCVA) and mean sensitivity (MS) by microperimetry and SD-OCTA assessment of vessel tortuosity (VT), vessel density (VD), foveal avascular zone, and retinal thickness (RT). Results: The findings showed statistically significant differences in VT, foveal avascular zone parameters, RT, BCVA, and MS between the iERM and control groups ( p < 0.05) . After iERM surgery, the macular VT, SCP VD, and RT decreased significantly ( p < 0.01) while the DCP VD increased ( p = 0.029). The BCVA improved significantly ( p < 0.001) and was associated with the MS (rs = -0.377, p = 0.015). MS was associated with the SCP VD and RT at 3M (SCP VD rs = 0.511, p = 0.001; RT rs = 0.456, p = 0.003). In the superior quadrant, the MS improved significantly ( p < 0.001) and the improvement of MS was associated with the reduction of VT ( β = -0.330, p = 0.034). Conclusion: Microcirculatory remodeling and perfusion recovery were observed within 3 months after iERM surgery. VT was a novel index for evaluating the morphology of the retinal microvasculature in eyes with iERM and was associated with MS in the superior quadrant., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Shen, Ye, Tao, Zhao, Xu, Mao, Chen and Shen.)

Introduction: This study aimed to examine the foveal stereo deviations in the different ectopic inner foveal layer (EIFL) stages of idiopathic epiretinal membrane (iERM) and assess its predictive utility for the baseline and postoperative best-corrected visual acuity (BCVA)., Methods: Based on the calculational combination of foveal displacements in the horizontal and vertical axial optical coherence tomography (OCT) images, the foveal stereotaxic displacement was estimated through the total distance (TD, the distance from the foveal bottom to the inner edge of displaced central foveal) and horizontal distance (HD, projection of the TD in the retinal plane). The preoperative TD, HD, and other OCT- and OCT angiography (OCTA)-related indicators were obtained. The correlations between structural parameters and baseline and postoperative BCVA were evaluated through correlation and multiple linear regression analyses., Results: In patients with advanced EIFL stage, there was a significant increase in the HD, TD, baseline log of the minimum angle of resolution unit for BCVA, central macular thickness (CMT), acircularity index, and incidence of microcystic macular edema (MME; p  < 0.05). Further, they showed a decreased foveal avascular zone (FAZ) area and perimeter ( p  < 0.001). HD, TD, CMT, MME, FAZ area, and FAZ perimeter were significantly correlated with the baseline and postoperative BCVA ( p  < 0.05). TD had the highest correlation indexic and was an individual predictor of the baseline and postoperative BCVA. Moreover, FD-300 and MME were individual predictors of postoperative BCVA., Discussion: Stereoscopic foveal deviations significantly correlated with the baseline and postoperative visual acuity. TD may be used as an independent prognostic factor for BCVA., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zhang, Mao, Lao, Chen, Deng, Chen, Tao, Chen and Shen.)

Purpose: To further evaluate the necessity of internal limiting membrane (ILM) peeling for patients with idiopathic epiretinal membrane (iERM)., Method: We searched PubMed, Web of Science, Embase, Cochrane Library, and CNKI from their inception up to August 24, 2021. Eligible meta-analyses comparing iERM removal with and without ILM peeling were included. AMSTAR and GRADE classification was used to assess the methodological quality of each study and the quality for each outcome, respectively. The primary outcomes were best-corrected visual acuity (BCVA), central macular thickness (CMT), and recurrence., Results: 10 meta-analyses were included. 75.9% of studies revealed no statistically significant difference in BCVA between the groups, while only 10.3% showed better BCVA favorable to additional ILM peeling. 54.2% reported no significant difference in CMT between the groups, followed by 41.7% showing thicker CMT due to additional ILM peeling. Compared to iERM removal alone, additional ILM peeling provided a lower recurrence rate in 66.7% of studies., Conclusion: ILM peeling could significantly reduce recurrence rate, but not significantly improve the recovery of visual outcome or decrease the thickness of central macula., Competing Interests: The authors declare no competing interests., (© 2023 The Authors. Published by Elsevier Ltd.)

Objective: To examine the effect of diabetes mellitus (DM) on results of pars plana vitrectomy plus membranectomy for idiopathic epiretinal membrane (ERM). Materials and Methods: In this retrospective study, data of patients who underwent pars plana vitrectomy (PPV) plus membranectomy for idiopathic ERM were collected in non diabetic patients (group 1) and diabetic patients (group 2). Preoperative and postoperative best corrected visual acuity (BCVA), central macular thickness (CMT) at 1st, 3rd, 6th, 9th, 12th and 18th months, follow-up time, presence of macular edema after PPV and recurrence of ERM were compared. Also the effect of peeling of internal limiting membran (ILM) was evaluated on BCVA and CMT. Results: Group 1 included 16 eyes of 16 patients (7 female, 9 male, mean age: 70.9±8.2 years) and group 2 included 19 eyes of 19 patients (8 female, 11 male, mean age: 66.2±7.2). Mean follow-up was 16.7±9.1 months in group 1 and 17.1±10.1 months in group 2 (p=0.949). BCVA was improved from 0.2±0.2 to 0.4±0.2 at 12 months and 0.4±0.3 at 18 months in group 1 (p<0.05) and from 0.3±0.2 to 0.5±0.2 at 12 months and 0.5±0.3 at 18 months in group 2 (p<0.05). Postoperative CMT was improved in all visits in both groups. There was no effect of peeling of ILM on long term results of BCVA and CMT. Conclusion: DM had no negative effect on results of PPV plus memranectomy for idiopathic ERM. Number of case who had decrease in BCVA and macular edema were higher in diabetic patients but this was not significant. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the influence of spectral-domain optical coherence tomography (SD-OCT) features on visual acuity changes in patients with idiopathic epiretinal membranes (ERMs). Methods: Seventy-nine eyes of 71 patients were included in this study. SD-OCT was performed for all patients; data were collected upon ERM diagnosis and at the final visit. The patients were divided into subgroups based on their SD-OCT features. The initial best corrected visual acuity (BCVA) and changes in BCVA for each subgroup were compared. A multivariate analysis was performed to assess the factors associated with changes in BCVA. Results: During a mean follow-up period of 20.78 months, the mean change in logMAR visual acuity was 0.052 ± 0.089. Eyes with inner segment/outer segment (IS/OS) junction disruption and cystoid macular edema (CME) had a significantly lower mean initial BCVA than those without disruption and CME ( P = 0.036 and P = 0.012, respectively). However, only eyes with CME had significant changes in BCVA ( P = .034). Multivariate analysis revealed the presence of CME as the only factor that had a significant correlation with VA changes. Conclusions: In patients with idiopathic ERMs, the presence of CME and IS/OS disruption detected by OCT correlated with a poorer initial BCVA. Most patients' visual acuity remained stable during follow-up. The presence of CME with OCT represented a predictor of the progression of visual acuity. These results may provide valuable clinical information regarding the management of patients with idiopathic ERMs. Specific note on abstract: We demonstrated that the presence of CME and IS/OS disruption detected with OCT correlated with a poorer BCVA in idiopathic ERMs. The visual acuity of most patients was stable during the follow-up period. The presence of CME in OCT represented a predictor of vision deterioration for patients with idiopathic ERMs. [ABSTRACT FROM AUTHOR]

Introduction: Integrated analysis of retinal and choroidal morphologic and vascular features is urgently needed to examine whether and how these two elements interact with each other, thus contributing to visual impairment in patients with idiopathic epiretinal membranes (iERMs)., Methods: An observational retrospective study consisting of 181 patients diagnosed with unilateral iERM between August 2019 and July 2022 was carried out at Peking University Third Hospital. All patients underwent a standardized set of ophthalmologic examinations, including EDI-OCT and OCTA scanning, and were subsequently categorized into four stages according to current classification schemes based on their OCT findings. Altogether, 15 qualitative and quantitative parameters of both the retina (full-layer, inner and outer layers) and choroid were identified., Results: The results revealed variations in the choroidal vascularity index (CVI) among different stages of iERMs ( p < 0.001) for the first time. Distributions of retinal parameters across four stages of iERMs were validated. Correlation analysis between choroidal and retinal parameters showed that the CVI was associated with both inner and outer retinal morphologic biomarkers. Functional damage to retinal integrity was determined to be a strong contributor to visual acuity reduction in iERMs., Discussion: This study complemented our present understanding of posterior segment structural and vascular alterations in iERMs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Wang, Yang, Wang and Li.)

Background: The purpose of this study was to investigate postoperative intraocular pressure (IOP) in cases of silicone oil (SO) removal when using 25-gauge transconjunctival sutureless vitrectomy (TSV) with oblique incisions. Methods: We enrolled ten consecutive eyes with SO removal (SO group) and eleven consecutive eyes with idiopathic epiretinal membrane (ERM) as the initial vitrectomy (ERM group) in cases using 25-gauge TSV with oblique incisions. Postoperative IOPs were compared between the two groups at each of the four examination periods. Results: No significant differences were identified in any of the periods examined. Conclusion: The use of 25-gauge TSV with oblique incisions resulted in almost equivalent postoperative IOPs between cases with SO removal and idiopathic ERM as the initial operation. Self-sealing sclerotomy in 25-gauge TSV with oblique incisions may primarily involve the valve architecture, and be complemented by vitreous incarceration. [ABSTRACT FROM AUTHOR]

Purpose: Pars plana vitrectomy with internal limiting membrane peeling for idiopathic epiretinal membrane has shown varying results. More data are needed on the factors associated with visual outcome. Methods: We extracted baseline clinical characteristics, optical coherence tomography (OCT) characteristics and 3-month postoperative best-corrected visual acuity (BCVA). Linear regression analysis was used to evaluate whether baseline and OCT characteristics are associated with BCVA at 3 months as well as BCVA difference. Results: Out of 82 operated eyes, 66 (80%) had a 3-month follow-up, and 47 (71%) showed a 3-month postoperative improvement. Preoperative BCVA was an independent determinant of postoperative BCVA (r = 0.31; p < 0.01) and BCVA difference (r = 0.68; p < 0.01). Other baseline and OCT characteristics showed no independent associations with postoperative outcome. Conclusion: Better preoperative BCVA predicts better postoperative BCVA. Other baseline and OCT characteristics are not associated with visual outcome 3 months after surgery. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Purpose: To investigate the natural history of idiopathic epiretinal membrane (ERM) in eyes with good visual function using optical coherence tomography (OCT). Methods: Sixty-two eyes of 58 patients with idiopathic ERM, visual acuity of 20/40 or better, and no significant metamorphopsia were included. The best corrected visual acuity (BCVA), central macular thickness (CMT), membrane configuration, and ellipsoid zone signal data over 24 months were retrospectively analyzed. Based on OCT findings, ERM configurations were categorized as global attachment (GA), partial attachment (PA), pseudohole, and vitreomacular traction (VMT). Results: The mean BCVA and CMT did not change significantly between baseline and 24 months. GA, PA, pseudohole, and VMT types were observed in 33, 19, 9, and 1 eye at baseline, and in 20, 22, 10, and 1 eye at 24 months, respectively. A membrane configuration change was noted in 24 eyes (38.7%) during follow-up, and the distribution shifted from GA to the other types (p < 0.001). Six eyes had visual loss due to membrane progression, and 4 eyes had spontaneous membrane separation. Of the 10 eyes with progression or separation, 6 were of the PA type. Conclusions: Although the BCVA remains stable over 2 years in most idiopathic ERM eyes with good visual function at baseline, the membrane configuration may change, affecting visual acuity. The GA type would be an early stage, and the PA type is prone to changes in visual acuity. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The aim of this study was to review the literature on predictive factors for postoperative visual acuity ( VA) in surgery for idiopathic epiretinal membrane ( ERM). A systematic review of the literature in the databases of PubMed and Embase was performed. The risk of bias was assessed based on predefined criteria and the results were summarized. In total, 1927 studies were retrieved of which 35 were potentially eligible. Nineteen studies were of adequate quality in terms of bias. Preoperative VA, central foveal thickness ( CFT) and inner segment/outer segment ( IS/ OS) integrity on optical coherence tomography ( OCT) were most extensively studied. Other preoperative factors studied were severity of metamorphopsia, several OCT parameters, fundus autofluorescence and multifocal electroretinogram. In the current literature, preoperative VA is the only variable consistently associated with postoperative VA. IS/ OS integrity on OCT is probably associated, and the severity of metamorphopsia, cone outer segment tips integrity and fundus autofluorescence are possibly associated with postoperative VA. CFT is not associated with postoperative VA. Further studies with adequate methodological quality are needed to confirm these findings. Therefore, an overall prediction model, including different parameters, is still awaited. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the correlation of visual acuity with the ganglion cell layer and the photoreceptor layer using spectral-domain optical coherence tomography after surgery for idiopathic epiretinal membrane (ERM). Methods: The medical records of 58 eyes were reviewed retrospectively to collect data on visual acuity (VA), ganglion cell complex thickness (GT) and photoreceptor reflectivity (PR) at baseline, 3 months, and 6 months after surgery. The GT was adjusted to compensate for tractional thickening by calculating the proportional thickness to the macular thickness (MT). The PR was adjusted to compensate for the shadowing effects from the inner retina, which was achieved by calculating the ratio to the retinal pigment epithelium reflectivity (RR). The relative GT (RGT = GT/MT) and relative PR (RPR = PR/RR) were analyzed to determine their correlation with visual acuity. Results: The GT was segmented correctly in 13 eyes at baseline, and in all eyes after surgery. The RGT and RPR were significantly lower than the normal eye. Thinner RGT correlated with poorer VA at 3 months ( R = −0.352, p = 0.007) and 6 months ( R = −0.324, p = 0.013), but the RPR had correlation with visual acuity only at 6 months ( R = −0.377, p = 0.004). The area under the receiver operating characteristic curve was significant for VA ≥ 20/30 in both the RGT and RPR, and this significance was present for visual acuity ≥ 0/25 only in the RGT. Conclusions: The postoperative ganglion cell layer was found to be correlated to postoperative VA more consistently than the photoreceptor layer after ERM surgery. The outer retinal damage was a determining factor in the poor VA group. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the Ganglion Cell Complex (GCC) thickness change and visual recovery correlation after surgery for an idiopathic epiretinal membrane (ERM). Methods: In this prospective, observational, case control study 30 eyes underwent vitrectomy for idiopathic ERM. We analysed best-corrected visual acuity (BCVA), mean macular thickness and mean GCC thickness one day before surgery, seven days and six months after surgery. Internal segment/outer segment junction, external limiting membrane, cone outer segment tips defects and intraretinalfluid were also investigated throughout the follow-up. Results: Baseline GCC thickness was higher in patients with ERM (130 ± 13 μm) compared with healthy eyes (94 ± 5 μm; p < 0.0001). GCC thickness decreased after surgery to 89 ± 11 μm ( p < 0.0001), reaching a value similar to controls ( p = 0.12). Preoperative macular thickness was 318 ± 32 μm and decreased to 281 ± 18 μm ( p < 0.0001), remaining significantly higher than controls (260 ± 8 μm; p < 0.0001). The GCC proportion of the whole macular thickness was also reduced six months after surgery ( p < 0.0001). Post-operative BCVA gain showed direct correlation with GCC reduction ( R = 0.67, p < 0.0001), but did not correlate with the mean macular thickness reduction ( R < 0.01, p = 0.97). Conclusions: Ganglion cell complex thickness is higher in eyes with idiopathic ERM, and after surgery turns back to similar values of healthy eyes. Post-operative GCC reduction is proportionally higher than thinning of the whole retina, and this reduction is correlated with visual restoration. [ABSTRACT FROM AUTHOR]

Background Characterization of the neuro-glial profile of cells growing out of human idiopathic epiretinal membranes (iERMs) and testing their proliferative and pluripotent properties ex vivo is needed to better understand the pathogenesis of their formation. Methods iERMs obtained during uneventful vitrectomies were cultivated ex vivo under adherent conditions and assessed by standard morphological and immunocytochemical methods. The intracellular calcium dynamics of the outgrowing cells was assessed by fluorescent dye Fura-2 in response to acetylcholine (ACh)- or mechano- stimulation. Results The cells from the iERMs formed sphere-like structures when cultured ex vivo. The diameter of the spheres increased by 5% at day 6 and kept an increasing tendency over a month time. The outgrowing cells from the iERM spheres had mainly glial- and some neuronal- like morphology. ACh- or mechano- stimulation of these cells induced intracellular calcium propagation in both cell types; in the neuronal-like cells resembling action potential from the soma to the dendrites. Immunocytochemistry confirmed presence of glial- and neuronal cell phenotype (GFAP and Nestin-1 positivity, respectively) in the iERMs, as well as presence of pluripotency marker (Sox2). Conclusion iERMs contain cells of neuronal- and glial- like origin which have proliferative and pluripotent potential, show functionality reflected through calcium dynamics upon ACh and mechano- stimulation, and a corresponding molecular phenotype. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the correlation of foveal photoreceptor integrity with visual outcome in patients undergoing idiopathic epiretinal membrane (ERM) surgery using spectral domain optical coherence tomography (SD-OCT). Materials and methods: Forty-three eyes of 43 patients were examined by SD-OCT before and at 1 and 6 months after vitrectomy for idiopathic ERM. Patients were divided into two groups based on the preoperative integrity of photoreceptor inner and outer segment junction (IS/OS) - Group I, intact IS/OS and Group D, disrupted IS/OS. Where present, disrupted length of IS/OS was measured, and the association between disrupted length of IS/OS and foveal thickness with best corrected visual acuity (BCVA) was evaluated. Results: There were 27 eyes with an intact IS/OS (Group I) and 16 eyes with a disrupted IS/OS (Group D). Patients in Group I had significantly better postoperative BCVA and greater improvement than those in Group D at 6 months after surgery ( p = 0.001 and p = 0.030, respectively). By 6 months after surgery, the disrupted length of IS/OS observed preoperatively in Group D had decreased significantly ( p = 0.007). The disrupted length of IS/OS before and at 6 months after the surgery in Group D showed a positive correlation with BCVA ( r = 0.632 and p = 0.009; r = 0.658 and p = 0.006, respectively). Foveal thickness did not correlate significantly with preoperative and postoperative BCVA. Conclusions: Preoperative disruption of foveal photoreceptors can be restored after ERM surgery. The preoperative integrity of foveal photoreceptors may be a clinically significant prognostic factor for visual recovery in patients with idiopathic ERM. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study was to characterize the idiopathic epiretinal membrane (iERM) through proteomics and phosphoproteomics analysis to facilitate the diagnosis and treatment of iERM., Experimental Design: The vitreous of 25 patients with an iERM and 15 patients with an idiopathic macular hole were analyzed by proteomic and phosphoproteomic analysis based on tandem mass tag. PRM was used to verify the differential proteins., Results: Proteomic analysis identified a total of 878 proteins, including 50 differential proteins. Tenascin-C, galectin-3-binding protein, glucose-6-phosphate isomerase, neuroserpin, collagen alpha-1(XI) chain, and collagen alpha-1(II) chain were verified to be upregulated in iERM by PRM. Phosphoproteomic analysis identified a total of 401 phosphorylation sites on 213 proteins, including 27 differential phosphorylation sites on 24 proteins. Mitogen-activated protein kinase-activated protein kinase (MAPKAPK)3 and MAPKAPK5 were predicted as the major kinases in the vitreous of iERM. Twenty-six of the differential proteins and phosphorylated proteins may be closely related to fibrosis in iERM., Conclusion and Clinical Relevance: Our results indicated the potential biomarkers or therapeutic targets for iERM, provided key kinases that may be involved in iERM. Fibrosis plays an essential role in iERM, and further exploration of related differential proteins has important clinical significance., (© 2022 Wiley-VCH GmbH.)

Epiretinal membrane (ERM) is a common retinal fibrotic disorder disease causing visual impairment and metamorphopsia. Recently, increasing attention has been devoted to ERM progression after uncomplicated cataract surgery. Cytokines, which play a role in diverse physiological and pathological activities in eyes, are suggested to be involved in these postoperative changes. However, few studies have investigated the post-cataract surgery cytokine expression changes in ERM eyes and their roles in the postoperative changes. The purpose of this study was to evaluate the aqueous levels of cytokines in eyes with idiopathic epiretinal membrane (iERM) both pre- and post-cataract surgery, and their correlations with postoperative iERM progression. In this study, aqueous humor (AH) samples were collected from iERM eyes (n = 25) and non-iERM eyes (n = 23) from 48 patients (48 eyes) undergoing uncomplicated cataract surgery preoperatively and 20 h postoperatively. Samples were analyzed for 48 cytokines with multiplex bead-based immunoassay. Correlations between cytokine level changes (postoperation vs. preoperation) and three-month postoperative best-corrected visual acuity (BCVA) and optical coherence tomography measure changes were evaluated in iERM eyes. We found that in iERM eyes, the levels of 4 cytokines exhibited significant elevations when compared with those in the controls (all p ≤ 0.0015) preoperatively. Postoperatively, the concentrations of 21 cytokines were higher than the preoperative levels in iERM eyes (all p ≤ 0.0015), among which GRO-α, IL-8, and MCP-3 levels showed more pronounced changes than the controls. Additionally, in iERM eyes, IL-4 level changes showed moderate positive correlations with MV (r = 0.492, p = 0.028) and MT (r = 0.481, p = 0.032) changes. LogMAR changes were positively correlated with IL-1α (r = 0.553, p = 0.011), IL-12(P40) (r = 0.544, p = 0.013), and MCP-3 (r = 0.588, p = 0.006) level changes. No significant cytokine-level-change differences were found between eyes with and without postoperative cystoid macular edema development. In conclusion, cataract surgery will bring great alterations to the specific intraocular cytokine microenvironment inherently in eyes with iERM. Many fibrotic and inflammatory cytokines showing elevated levels or relationships with clinical characteristics are suggested to be involved in the pathogenesis and post-cataract surgery progression of iERM; however, further investigations are needed to discern their real roles. • IERM eyes have unique aqueous cytokine environment pre- and post-cataract-surgery. • GRO-α, IL-2, IL-7, and PDGF-BB may take part in the pathogenesis of iERM. • Eyes with iERM exhibit worse recovery outcomes post cataract surgery. • New cytokines are found involved in the post-cataract-surgery development of iERM. [ABSTRACT FROM AUTHOR]

PurposeTo assess the course of macular thickness change in relation to visual acuity improvement, in patients being operated for idiopathic epimacular membrane by 23-gauge pars plana vitrectomy.Materials and methodsThe clinical charts of 21 eyes of 19 consecutive patients (9 male and 10 female) were assessed retrospectively. Postoperatively, patients were followed up by best-corrected Snellen visual acuity (BCVA), a thorough ophthalmological examination, including fundoscopy, retinal thickness, and macular morphology as demonstrated by optical coherence tomography. The main outcome measures of the study were changed in central macular thickness (CMT)and visual acuity during the follow-up period.ResultsThe mean duration of follow-up was 15.9±1.0 months (range 12-24 months). Mean baseline BCVA improved from 0.22±0.03 (decimal fraction) to 0.50±0.07 at the last visit (P=0.001), whereas baseline CMT (408 μm) decreased to 283 μm at final examination (P=0.001). During the follow-up, 10 eyes (47%) achieved 0.5 or better BCVA. The first significantly lower CMT readings were obtained at third-month visit while BCVA showed an improvement with the significant difference following 9 months after the surgery. In total, 8 out of 11 phakic eyes underwent cataract extraction with a mean of 6.8 months (range 1-12 months).ConclusionsAfter a successful epimacular membrane removal, functional recovery takes at least 9 months in comparison to much early resolution in macular oedema that was evident at third month following the surgery. [ABSTRACT FROM AUTHOR]

PurposeTo examine whether or not phacoemulsification surgery accelerates the progression of idiopathic epiretinal membrane (ERM) by measuring the degree of ERM.MethodsForty-three consecutive eyes with idiopathic ERM that underwent phacoemulsification surgery were recruited; 41 consecutive eyes with ERM that did not undergo surgery served as controls. Foveal thickness and macular volume were measured using optical coherence tomography at 3 days after surgery (baseline), and at 3, 6, and 12 months after baseline. Visual acuity and the incidence of eyes that underwent ERM peeling surgery were also examined.ResultsThere were no significant differences in the foveal thickness and macular volume between the two groups at baseline. The foveal thickness gradually increased by 7.0% in the cataract surgery (CS) group by 5.3% in the no surgery group at 12 months after surgery. When comparing the groups, no significant differences were found in the foveal thickness, macular volume, or their percentage increases from baseline throughout the 12–month follow-up period. Only one eye in the CS group underwent ERM peeling surgery within the 12 months. Mean visual acuity did not worsen significantly in either group during follow-up.ConclusionProgression of idiopathic ERM is not accelerated by phacoemulsification surgery.Eye (2009) 23, 774–779; doi:10.1038/eye.2008.161; published online 6 June 2008 [ABSTRACT FROM AUTHOR]

Purpose: To investigate the relationship between ophthalmic parameters-including optical coherence tomography (OCT) and OCT angiography findings-and foveal pit restoration in eyes that had undergone vitrectomy for idiopathic epiretinal membrane (iERM) removal., Methods: This study retrospectively analyzed data of patients who underwent pars planar vitrectomy for the removal of epirentinal membrane. Only eyes with iERM above stage 2 with a follow-up over 6 months were included. Baseline data and changes in ophthalmic parameters were analyzed from 3 months before to 12 months after surgery. Additionally, we stratified iERM patients into two groups (foveal pit restoration and no restoration group). Longitudinal comparison analyses between the two groups were done in best-corrected visual acuity (BCVA), central foveal thickness (CFT) and foveal avascular zone (FAZ) areas measurements using swept-source OCT and OCT angiography., Results: Forty-three patients with a mean age of 75 ± 5 years were enrolled. After surgery, BCVA, FAZ, and CFT showed improvements over time (all p < 0.002). Thirty-one patients were designated into the foveal pit restoration (R) group and 12 patients into the no restoration (NR) group. Differences in BCVA and FAZ area in both groups existed up to 6 months. However, BCVA improved and FAZ expanded (R, 0.20 ± 0.05 vs. NR, 0.18 ± 0.04) in both groups showing no statistical difference 12 months postsurgery. The CFT decreased in both groups, but the R group was thinner at every point compared to the NR group (all p < 0.05)., Conclusions: The removal of epirentinal membrane in pars planar vitrectomy significantly improves BCVA, decreases the CFT and expands the FAZ. Foveal pit restoration improves BCVA, CFT, and FAZ area possibly at a faster rate in the early months but long-term improvements could be achieved regardless of the status of foveal pit restoration.

Background: The present study examined the relationships among retinal structure, peripheral retinal abnormalities, and epiretinal membrane (ERM) and explored the utility of ultra-wide-field laser scanning ophthalmoscopy in idiopathic ERM assessment. Methods: The study sample comprised 276 eyes of 276 patients. Ultra-wide field fundus imaging was performed without mydriasis using Optos California. Each patient underwent a Goldmann three-mirror contact lens fundus examination. Results: Ultra-wide field laser scanning ophthalmoscopy revealed peripheral retinal degeneration in 84 (54.54%) eyes in the ERM and in 28 (22.95%) eyes in the control group. Goldmann three-mirror contact lens examination revealed peripheral retinal degeneration in 96 (62.33%) eyes in the ERM group and 42 (34.42%) eyes in the control group. Ultra-wide field ophthalmoscopy enabled the detection of nearly 87% of all peripheral retinal lesions in patients with ERM, but it cannot replace fundus examination with a Goldmann triple mirror or ophthalmoscopy with scleral indentation. Conclusions: In most patients, idiopathic ERM coexisted with changes in the peripheral retina. Some of these changes promote retinal detachment. Thus, surgeons should consider the risk of retinal tear during vitrectomy, which increases the scope of surgery and may adversely affect prognosis. Although ultra-wide field imaging is a valuable diagnostic method, it is not a substitute for Goldmann three-mirror contact lens fundus examination or ophthalmoscopy with scleral indentation. [ABSTRACT FROM AUTHOR]

Background: The present study examined the relationships among macular microvasculature, retinal structure, and epiretinal membrane (ERM) and explored the utility of optical coherence tomography (OCT) angiography (OCTA) in idiopathic ERM assessment., Methods: The study sample comprised 276 eyes of 276 patients. A total of 154 eyes with ERM and 122 normal (control) eyes were analyzed. Only one eye of each participant was randomly selected for posterior segment imaging. Each patient underwent OCT and OCTA. Images were analyzed with AngioTool 0.6., Results: Foveal avascular zone was significantly smaller in the ERM group ( p = 0.044). Average retinal thickness and foveal thickness were significantly higher in the ERM group (both p = 0.001). Moreover, 64 (41.5%) patients exhibited no metamorphopsia, while 46 (29.8%) and 44 (28.7%) patients exhibited moderate and extensive metamorphopsias, respectively. Meanwhile, FAZ was negatively correlated with central retinal thickness in the ERM group. The vessel area ( p = 0.0017) and vessel percentage area ( p = 0.044) were significantly greater in the ERM group., Conclusions: Changes observed in the superficial plexus in OCTA are related to the severity of metamorphopsia and can be further evaluated to support decision making regarding the surgical management of idiopathic ERM.

Purpose: To investigate the correlation between outer and inner retina optical coherence tomography (OCT) biomarkers and visual acuity in patients with idiopathic epiretinal membrane (iERM) and identify which of them may be predictive of visual function., Methods: A retrospective cross-sectional single-center study was conducted that included patients diagnosed with iERM. Spectral domain OCT images were obtained and assessed qualitatively and quantitatively. The association of OCT parameters with best corrected visual acuity was analyzed., Results: Charts of 97 eyes of 97 patients were reviewed. Central foveal thickness, maximal retinal thickness (MRT), photoreceptor outer segment length, outer foveal thickness, ganglion cell-inner plexiform layer complex thickening, inner retinal thickness and inner retinal layer irregularity index were among the major outcome measures. OCT scans were also assessed for the presence of cotton ball sign, ellipsoid zone disruption, ectopic inner foveal layer, disorganization of retinal inner layers (DRIL), intraretinal fluid, subretinal fluid (SRF) and epimacular membrane rip. Univariate analysis showed statistically significant association between all the aforementioned parameters with worse vision, except for cotton ball sign and SRF. Multivariate analysis found that MRT and severe DRIL were strongly correlated with worse vision ( p  < 0.001)., Conclusion: MRT and severe DRIL should be considered as negative prognostic factors for visual acuity.