LONGITUDINAL ELLIPSOID ZONE AND OUTER RETINAL INTEGRITY DYNAMICS AFTER EPIRETINAL MEMBRANE SURGERY

Area of Science:

• Ophthalmology
• Retinal Surgery
• Medical Imaging

Background:

• Epiretinal membranes (ERMs) can impair vision by affecting retinal integrity.
• Quantifying changes in the ellipsoid zone (EZ) is crucial for understanding visual outcomes after ERM surgery.

Purpose of the Study:

• To quantify ellipsoid zone (EZ) integrity changes after epiretinal membrane (ERM) surgery.
• To correlate these EZ changes with visual acuity outcomes.
• To identify predictors of prognosis following ERM surgery.

Main Methods:

• A post hoc analysis included 177 eyes undergoing ERM surgery (DISCOVER and conventional arms).
• Quantitative EZ features were extracted using a machine learning-enabled automated segmentation platform.
• Visual acuity and EZ integrity were assessed pre- and post-surgery, with regression analysis performed to identify predictors.

Main Results:

• ERM surgery led to significant improvements in visual acuity and EZ integrity metrics, including reduced EZ partial attenuation and increased EZ-retinal pigment epithelium (RPE) volume.
• Reduced EZ partial attenuation and increased EZ-RPE central subfield thickness (CST) correlated significantly with improved visual acuity.
• Higher baseline EZ-RPE CST predicted visual acuity improvement post-surgery.

Conclusions:

• Longitudinal assessment reveals significant postoperative improvement in EZ integrity metrics after ERM surgery.
• Enhanced EZ integrity correlates with improved visual acuity.
• EZ integrity and visual acuity are valuable predictors for clinical prognostication after ERM surgery.