ECTOPIC INNER FOVEAL LAYER CLASSIFICATION SCHEME PREDICTS VISUAL OUTCOMES AFTER EPIRETINAL MEMBRANE SURGERY

Area of Science:

• Ophthalmology
• Retinal Surgery
• Visual Prognosis

Background:

• Epiretinal membranes (ERMs) can impair vision.
• Predicting visual outcomes after ERM surgery is crucial for patient management.

Purpose of the Study:

• To assess the ectopic inner foveal layer (EIFL) staging scheme as a predictor of visual prognosis in patients undergoing ERM surgery.
• To correlate preoperative and postoperative EIFL stages with final best-corrected visual acuity (BCVA).

Main Methods:

• Retrospective analysis of 88 pseudophakic patients with idiopathic ERM.
• Evaluation of preoperative and postoperative EIFL staging.
• Correlation of EIFL stages with final BCVA and achievement of BCVA ≥20/40.

Main Results:

• Preoperative EIFL staging: 27.4% Stage 2, 51.1% Stage 3, 21.5% Stage 4.
• Improvement in EIFL staging observed in 70.8% of Stage 2 eyes; 68% of Stage 3 and 4 eyes remained unchanged.
• Earlier EIFL stages correlated with significantly better preoperative and postoperative BCVA (Stage 2 > Stage 3 > Stage 4; P < 0.001).
• Final BCVA ≥20/40 achieved by 91.7% of Stage 2, 42.3% of Stage 3, and 5.2% of Stage 4 eyes.

Conclusions:

• The EIFL staging scheme is a reliable method for predicting visual prognosis in ERM surgery.
• Stage 2 ERM surgery yields superior visual outcomes and greater potential for anatomical change reversal.
• The EIFL staging scheme is easy, fast, and reproducible for clinical use.