LAYER-SPECIFIC MICROVASCULAR CHANGES IN IDIOPATHIC EPIRETINAL MEMBRANE: Implications for Visual Function

Area of Science:

• Ophthalmology
• Retinal Imaging
• Vascular Biology

Background:

• Idiopathic epiretinal membrane (iERM) affects vision by distorting retinal layers.
• Assessing microvascular changes in iERM is crucial for understanding visual outcomes.
• Optical coherence tomography angiography (OCTA) offers high-resolution imaging of retinal vasculature.

Purpose of the Study:

• To investigate layer-specific microvascular changes in the nerve fiber layer plexus (NFLP) and ganglion cell layer plexus (GCLP) using OCTA.
• To correlate these microvascular changes with visual outcomes after iERM surgery.
• To compare the diagnostic and prognostic value of NFLP and GCLP metrics with the superficial vascular complex (SVC).

Main Methods:

• Retrospective analysis of 47 eyes with iERM and 30 healthy controls.
• Assessment of best-corrected visual acuity (BCVA), retinal sensitivity, and OCTA-derived vascular density (VD) in NFLP, GCLP, and SVC.
• Correlation and regression analyses to evaluate diagnostic accuracy and prognostic value.

Main Results:

• Preoperatively, iERM eyes showed increased VD and PA in NFLP, GCLP, and SVC compared to controls.
• NFLP metrics demonstrated superior diagnostic accuracy over SVC.
• Preoperative NFLP vascular metrics correlated with higher BCVA improvement, while GCLP metrics correlated with lower BCVA improvement.
• Preoperative GCLP VD independently predicted better final BCVA and higher retinal sensitivity post-surgery.

Conclusions:

• Stratified OCTA analysis of NFLP and GCLP provides distinct biomarkers for iERM.
• NFLP metrics are valuable for diagnosis.
• Preoperative GCLP integrity is a key predictor of postoperative functional recovery, offering more insight than SVC analysis.