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Correlation between internal limiting membrane preservation and sub-epiretinal membrane space during epiretinal
Naoki Horiuchi1,2, Norihiro Nagai1, Rihito Ui1
1Department of Ophthalmology, Kitasato Insititute Hospital, Kitasato University, Tokyo, Japan.
Japanese Journal of Ophthalmology
|January 23, 2025
Summary
A larger distance between the epiretinal membrane (ERM) and internal limiting membrane (ILM) increases the likelihood of preserving the ILM during ERM surgery. This distance can serve as a biomarker to minimize neuroretinal damage in glaucoma patients.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Glaucoma Management
Background:
- Internal limiting membrane (ILM) peeling is often performed with epiretinal membrane (ERM) removal.
- Preserving ILM is crucial in glaucoma patients to prevent nerve fiber layer damage.
Purpose of the Study:
- To evaluate a novel ERM surgical approach for ILM preservation.
- To determine if ERM-ILM distance is a predictor of successful ILM preservation.
Main Methods:
- Retrospective analysis of 33 eyes undergoing ERM surgery.
- Direct ERM grasping with forceps at maximum submembrane space.
- Brilliant blue G staining for ILM visualization and grading.
- ROC curve analysis to correlate ERM-ILM distance with ILM preservation.
Main Results:
- ILM was preserved in 63.6% of cases (21/33 eyes).
- Mean ERM-ILM distance was 80.5 ± 36.0 μm.
- A cutoff ERM-ILM distance of 66 μm predicted ILM preservation (AUC: 0.7143).
Conclusions:
- Larger ERM-ILM distances are associated with successful ILM preservation.
- ERM-ILM distance is a potential biomarker for guiding ILM preservation strategies.
- This approach may help minimize neuroretinal damage in glaucoma patients undergoing ERM surgery.
