Clinical-pathologic correlation: vitrectomy with epiretinal and internal limiting membrane peel.

Area of Science:

• Ophthalmology
• Retinal Surgery
• Surgical Pathology

Background:

• Epiretinal membranes (ERM) and internal limiting membranes (ILM) are often targeted in vitreoretinal surgery.
• Accurate intraoperative differentiation of these membranes can be challenging.

Purpose of the Study:

• To correlate clinical diagnoses with pathologic findings for ERM and ILM peels.
• To assess the frequency of combined ERM-ILM specimens.

Main Methods:

• Retrospective review of 698 vitrectomy specimens from 2008-2012.
• Analysis of clinical and pathology reports for ERM and/or ILM peels.

Main Results:

• Discrepancies between operative and pathologic diagnoses occurred in over 43% of cases.
• Combined ERM-ILM diagnoses were dominant both clinically and pathologically.
• Pathology revealed incongruous specimens in a significant percentage of cases labeled as ERM, ILM, or ERM-ILM.

Conclusions:

• Intraoperative distinction between ERM and ILM can be difficult.
• Combined ERM-ILM specimens may be more prevalent than previously thought.
• The findings suggest ERM and ILM are not always surgically separable.