Association between macular microstructural alterations and visual function following surgery for idiopathic...

To investigate alterations in macular microstructure and visual function before and after surgical intervention for idiopathic epiretinal membrane (iERM).

A retrospective case series was conducted involving 26 eyes from 26 patients diagnosed with iERM at the Affiliated Eye Hospital of Nanchang University between May and August 2022. Evaluated parameters included central foveal thickness (CFT), cone outer segment tip (COST) line length, ellipsoid zone (EZ) disruption diameter, extent of disorganization of retinal inner layers (DRIL), and ganglion cell-inner plexiform layer (GC‒IPL) thickness. Visual function was assessed using best-corrected visual acuity (BCVA) expressed in logarithmic minimum angle of resolution (logMAR) units and metamorphopsia severity measured by the M-score.

Significant improvements in BCVA were observed at 1-, 3-, and 6-months following surgery (p < 0.05). Both CFT and DRIL extent were significantly reduced at all postoperative timepoints (p < 0.05). Significant differences in COST line length and EZ disruption diameter were noted at 3 and 6 months postoperatively (p < 0.05). Postoperative improvements in BCVA were significantly correlated with reductions in CFT across all timepoints and with changes in COST length and GC-IPL thickness at 3 and 6 months (p < 0.05). Greater preoperative DRIL extent and EZ disruption diameter were positively correlated with worse BCVA at all postoperative timepoints (p < 0.01). Changes in CFT, COST line length, and GC-IPL thickness were significantly associated with corresponding changes in M-scores (p < 0.05). DRIL extent was significantly associated with M-scores at 1 and 3 months (p < 0.05).

Surgical intervention for iERM led to significant improvements in both BCVA and metamorphopsia. Recovery of visual function was significantly associated with specific macular microstructure alterations, particularly changes in CFT, COST line length, DRIL extent, and GC-IPL thickness.