Visual Acuity Correlations of Preoperative OCT Morphological Parameters After Phacovitrectomy for Epiretinal Membrane

The aim of this study was to demonstrate a possible correlation between qualitative preoperative OCT morphological changes in epiretinal membrane (ERM) and best corrected visual acuity (BCVA).

A total of 201 patient eyes with idiopathic symptomatic ERM and cataracts were included in the retrospective study. Phacovitrectomy was performed between 2015 and 2019.

ERM was classified into five OCT morphotypes. The first three corresponded to the ERM classification according to Govetto et al., Stages 1-3 without a tractional component, while the last two each had a tractional component in the sense of a lamellar macular hole and vitreomacular traction. A significant difference in preoperative BCVA was observed between all OCT morphotypes (p < 0.01). For OCT morphotypes without a tractional component, a negative correlation (p < 0.05) was observed between postoperative BCVA and lesions of the outer foveal layers (damaged retinal pigment epithelium, disrupted ellipsoid zone, and external limiting membrane). Nonedematous lesions of the inner foveal layers (detachment of the outer nuclear layer, depth of retinal layer distortion, breakage and distortion of retinal nerve fiber layers, and ERM separation) showed no correlation with either preoperative or postoperative BCVA in all OCT morphotypes (p > 0.05). Likewise, edematous changes in the inner foveal layers played no role in pre- and postoperative visual acuity prognosis (p > 0.05).

Preoperative OCT morphological changes in the inner foveal layers have no significance in postoperative visual acuity prognosis in ERM, in contrast to lesions of the outer central retinal layers.