Microvascular changes after vitrectomy with internal limiting membrane peeling: an optical coherence tomography...

Area of Science:

• Ophthalmology
• Retinal Surgery
• Vascular Imaging

Background:

• Idiopathic epiretinal membrane (ERM) affects the inner retinal layers.
• Internal limiting membrane (ILM) peeling is a common surgical step for ERM treatment.
• Superficial capillary plexus (SCP) is crucial for retinal health.

Purpose of the Study:

• To evaluate changes in the superficial capillary plexus (SCP) after internal limiting membrane (ILM) peeling.
• To assess the impact of ILM peeling on SCP vessel density in patients with idiopathic ERM.

Main Methods:

• 15 patients with idiopathic ERM underwent pars plana vitrectomy with ERM and ILM peeling.
• Ophthalmologic evaluations and optical coherence tomography angiography (OCTA) were performed at baseline, 1 week, and 1 month post-surgery.
• Superficial capillary plexus (SCP) vessel density was quantified using OCTA.

Main Results:

• Overall SCP vessel density showed no significant change from baseline throughout the follow-up period.
• A significant reduction in SCP vessel density was observed in superior and inferior sectors at the 1-week follow-up.
• This reduction in specific sectors persisted at the 1-month follow-up visit.

Conclusions:

• Pars plana vitrectomy with ILM peeling is associated with a localized reduction in SCP vessel density.
• The observed decrease in vessel density may be attributed to direct surgical trauma to the inner retina during ILM grasping.
• These vascular changes occur in areas previously noted for other retinal alterations, such as arcuate nerve fiber layer swelling.