PATHOGENESIS OF ECTOPIC INNER FOVEAL LAYERS AND ITS IMPACT ON VISUAL RECOVERY AFTER EPIRETINAL MEMBRANE PEELING

To determine the pathoanatomical alteration of ectopic inner foveal layers (EIFLs) and its relationship to visual recovery after epiretinal membrane peeling surgery.

Clinical charts and tracked spectral domain optical coherence tomography images of patients diagnosed with Stages 3 and 4 epiretinal membrane were reviewed and analyzed preoperatively and at 3 and 6 months postoperatively. Central macular thickness and EIFL thickness were measured at these time points. The Wilcoxon signed-rank test was used for analysis, and P < 0.05 was considered statistically significant.

The study cohort consisted of 54 eyes of 54 patients, 27 of whom were female. The mean age was 69.2 years. The mean Snellen visual acuity improved from 20/50 preoperatively to 20/35 at 3 months ( P < 0.001) and remained 20/35 at 6 months, significantly better than preoperative levels ( P = 0.002). The mean preoperative EIFL thickness was 169.15 µ m and decreased to 95.70 µ m at 3 months ( P = 0.001) and 90.95 µ m at 6 months ( P = 0.02). Similarly, central macular thickness reduced from 510.00 µ m preoperatively to 444.56 µ m at 3 months ( P < 0.001) and 415.50 µ m at 6 months ( P < 0.001). Reduction in EIFL thickness was significantly correlated with improvement in logMAR visual acuity ( P =0.02) 6 months after surgery.

Epiretinal membrane peeling results in reduced EIFL thickness, restoration of the normal foveal pit structure, and corresponding improvement in visual acuity. Reduction in EIFL thickness is correlated with visual improvement.