Pars Plana Vitrectomy for Idiopathic Epiretinal Membrane

Objective To investigate optical coherence tomography (OCT)-based biomarkers of visual acuity (VA) in eyes with idiopathic epiretinal membranes (ERM) undergoing surgical intervention. Purpose To assess surgical outcomes of pars plana vitrectomy (PPV) and membrane peel (MP) surgery in eyes with idiopathic ERM and identify potential imaging-based biomarkers of vision outcomes. Methods Retrospective, consecutive case series of eyes with idiopathic ERM that underwent PPV and MP surgery between 1/1/2017 and 1/1/2019. A previously described ERM grading scale was utilized for OCT analysis. The primary outcome was VA at post-operative month 6 and final follow-up. A secondary outcome was the association of OCT structural features, including ectopic inner foveal layers (EIFL), inner microcystoid changes, and ellipsoid zone (EZ) disruption, with VA outcomes. Results A total of 322 eyes with idiopathic ERM were included. Mean (± SD) follow-up was 506.6 ± 324.6 days after MP surgery. VA improved from logMAR 0.49 ± 0.27 (Snellen 20/61) pre-MP to 0.41 ± 0.30 (Snellen 20/51, p Conclusions VA improvement was noted after surgery in eyes with idiopathic ERM across all stages. Pre-operative stage 4 characteristics were associated with worse VA at 6 months. Post-operative inner microcystoid changes and EZ disruption at month 3 were additional OCT biomarkers associated with worse 6 month and final VA outcomes.