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Clinical and Optical Coherence Tomography Analysis of Intraretinal Microcysts in Patients with Epiretinal Membrane
Mete Güler1, Selma Urfalıoğlu1, Elif Damar Güngör2
1Department of Ophthalmology; Kahramanmaraş Sütçü Imam University School of Medicine, Kahramanmaraş, Turkey.
Abstract:
Purpose: To perform clinical and optical coherence tomography analysis of intraretinal microcysts (IRM) in patients undergoing pars plana vitrectomy (PPV) for primary epiretinal membrane (ERM) treatment.Materials and Methods: The files of 137 patients who were operated on by a single surgeon for primary epiretinal membrane treatment in our clinic between September 2017 and January 2020 were retrospectively reviewed. Patients with ERM due to secondary pathology were excluded from the study. Twenty patients with post-operative IRM (group 1) were determined and were included as the study group. To determine the effect of IRMs on visual acuity 20 patients who did not have IRM, had primary ERM and underwent PPV for treatment were included as the control group (group 2). The demographic, clinical, and operative data of the patients were obtained from the hospital database. Retinal analysis of the patients before the operation and at the earliest 6 months after the operation was performed using 6 × 6 mm images taken with the macular cube 512 × 128 protocol on the Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA, USA) device in our clinic.Results: Intraretinal microcysts were present in 8 (5.8%) of preoperative 137 patients and 20 (14.6%) of 137 postoperative patients. All 8 patients with preoperative cysts in group 1 also had postoperative IRMs. Excluding patients with preoperative cysts, the postoperative IRM incidence was found to be 12/137 (8.75%). Preoperative (p = .392) and postoperative (p = .978) visions were similar in group 1 and group 2. Preoperative (p = .745) and postoperative retinal thicknesses were similar in both groups (p = .989). The incidence of postoperative (p = .642) IRM was similar in patients who underwent ERM and ERM + internal limiting membrane (ILM) peeling in group 1.Conclusions: Intraretinal microcysts may sometimes be seen before and after ERM surgery. The preoperative cyst presence in ERM patients is an important risk factor for postoperative cyst presence. The peeling of ILM with ERM does not increase the probability of IRM occurrence. The presence of these cysts before and/or after the operation does not affect the visual prognosis and macular thickness in ERM patients.
Insights
Intraretinal microcysts can appear before and after epiretinal membrane (ERM) surgery. Preoperative cysts are a risk factor for postoperative ones, but neither impacts visual prognosis or macular thickness.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Optical Coherence Tomography
Background:
- Epiretinal membrane (ERM) surgery, specifically pars plana vitrectomy (PPV), is a common procedure.
- Intraretinal microcysts (IRM) can be a postoperative finding, but their prevalence and impact require further investigation.
Purpose of the Study:
- To analyze the clinical and optical coherence tomography (OCT) findings of IRM in patients undergoing PPV for primary ERM.
- To determine the incidence and risk factors for IRM development post-ERM surgery.
- To assess the effect of IRM on visual acuity and macular thickness.
Main Methods:
- Retrospective review of 137 patients undergoing PPV for primary ERM.
- Comparison of 20 patients with postoperative IRM (Group 1) against 20 controls without IRM (Group 2).
- Preoperative and postoperative OCT imaging using Cirrus HD-OCT (Carl Zeiss Meditec).
Main Results:
- IRM were present preoperatively in 5.8% and postoperatively in 14.6% of patients.
- Preoperative IRM was a significant risk factor for postoperative IRM.
- No significant differences in preoperative or postoperative visual acuity or retinal thickness were observed between groups.
- Internal limiting membrane (ILM) peeling did not increase the incidence of IRM.
Conclusions:
- IRM can occur before and after ERM surgery.
- Preoperative IRM presence is a risk factor for postoperative IRM.
- IRM presence does not negatively impact visual prognosis or macular thickness after ERM surgery.
- ILM peeling does not increase the likelihood of IRM formation.

