Vitrectomy for Epiretinal Membranes: Ganglion Cell Features Correlate with Visual Function Outcomes

Area of Science:

• Ophthalmology
• Retinal Imaging
• Visual Function Assessment

Background:

• Epiretinal membrane (ERM) affects visual acuity and can necessitate surgical intervention.
• Vitrectomy with internal limiting membrane (ILM) peeling is a standard surgical approach for ERM.
• Understanding the impact of ILM peeling on retinal microstructure and visual function is crucial for patient outcomes.

Purpose of the Study:

• To investigate the relationship between retinal microstructure and central visual field sensitivity (CVFS) after vitrectomy with ILM peeling for ERM.
• To evaluate changes in retinal layers and visual field sensitivity using swept-source OCT and Humphrey Field Analyzer (HFA).

Main Methods:

• A retrospective case series of 45 eyes with ERM undergoing vitrectomy with ILM peeling (using ICG or TA staining).
• Retinal microstructure (retinal thickness, GCC thickness, outer retinal layer thickness) and CVFS were assessed using SS-OCT and HFA 10-2 preoperatively and at 3 and 12 months postoperatively.
• Comparison with normal contralateral eyes and subgroup analysis based on staining dye (ICG vs. TA).

Main Results:

• Inner and outer temporal GCC thickness decreased significantly post-surgery compared to controls.
• While overall CVFS showed no significant change, outer nasal CVFS was reduced at 3 months post-surgery.
• Postoperative CVFS significantly correlated with GCC thickness (r=0.557, P<0.001).
• ICG staining was associated with reduced nasal CVFS and temporal GCC thickness.

Conclusions:

• Central visual field sensitivity (CVFS) in eyes with ERM after vitrectomy with ILM peeling is associated with ganglion cell complex (GCC) thickness.
• Combined SS-OCT and HFA 10-2 analysis provides detailed insights into postoperative retinal microstructure and function.
• The findings underscore the importance of assessing both structural and functional recovery after ERM surgery.