Biomarkers predictive of visual outcome in idiopathic epiretinal membrane

To assess the usefulness of clinical, and structural biomarkers obtained by Spectral-Domain Optical Coherence Tomography (SD-OCT), as predictors of visual outcome after idiopathic epiretinal membrane (iERM) surgery.

This was a retrospective, observational, and analytical study of 50 eyes from 50 patients who underwent iERM surgery. We studied preoperative best-corrected visual acuity (BCVA) as a clinical biomarker, and the following structural SD-OCT biomarkers: preoperative (Pre) and postoperative (Post) central macular thickness (CMT); Pre Govetto stage; and the presence of Pre ectopic inner foveal layers (EIFL), disorganization of retinal inner layers (DRIL), outer layer disruption (OLD), and interdigitation zone disruption (IZD).

Ten eyes were included in stage 2, 27 in stage 3, and 13 in stage 4. Pre BCVA was 0.96 ± 0.36 LogMAR, Post was 0.65 ± 0.43 LogMAR. Preoperative CMT was 425.4 ± 91.5 µm, Post was 338.5 ± 73.6 µm. Significant differences were found in Post BCVA between stages, with a trend toward worse BCVA in more advanced stages. A moderate-to-strong positive correlation was found between Pre BCVA and Post BCVA. Post BCVA did not correlate with Post CMT, but it did with Pre CMT. Patients with one or more of the EIFL, DRIL, DCE, and DZI biomarkers tended to have a worse visual outcome.

A worse initial BCVA, greater Pre CMT, and the presence of EIFL, DRIL, DCE, and/or DZI (associated with more advanced stages) translate to poorer postoperative vision. Early surgery could confer a higher probability of a better visual outcome.