[Anatomical and functional repercussions of internal limiting membrane peeling in epiretinal membrane surgery]

We report the case of a 67-year-old woman who underwent epiretinal membrane surgery with internal limiting membrane peeling via a 23-gauge vitrectomy. Postoperative OCT and fundus photography revealed two forms of cicatrization: a dissociation of the retinal nerve fiber layer (DONFL) over the entire area of internal limiting membrane peeling, and an arcuate zone of retinal nerve fiber layer swelling (SANFL) at the site where the peeling had been initiated. Functionally, the patient demonstrated improved postoperative near acuity and a decrease in metamorphopsia. Mean retinal sensitivity measured by MP1 microperimetry at 3months was reduced by more than 30%. Microscotomata are more marked in the zone of inititation of peeling.