J Korean Ophthalmol Soc.  2018 Apr;59(4):347-354. 10.3341/jkos.2018.59.4.347.

The Correlation between Preoperative En Face Optical Coherence Tomography and Postoperative Visual Prognoses in Idiopathic Epiretinal Membranes

• Ahn SH
• Lee TE
• You IC
• Ahn M
• Cho NC
• Jeong JG

• KMID: 2409683
• DOI: http://doi.org/10.3341/jkos.2018.59.4.347

Abstract

PURPOSE
To investigate the correlation between en face optical coherence tomography and improvements in the postoperative prognoses of idiopathic epiretinal membranes.
METHODS
The medical records of 59 epiretinal membrane patients who had epiretinal membrane peeling between January 2005 and January 2016, and were followed up for > 12 months, were retrospectively reviewed. The preoperative en face images were divided into four sections involving three circular areas (6,000 µm diameter circle, 3,000 µm diameter circle, and 1,000 µm diameter circle) and one square (6,000 × 6,000 µm). The surface area where no epiretinal adhesion was present was quantified by measuring the number of black pixels using image-editing software (Adobe Photoshop CS6, Adobe Systems, San Jose, CA, USA). Then the correlations among the value of black pixels, preoperative and postoperative visual acuities, and central retinal thickness were analyzed.
RESULTS
The best-corrected visual acuity (BCVA) was significantly increased after epiretinal membrane peeling (p < 0.001), and the central retinal thickness was significantly decreased (p < 0.001). As the number of black pixels in the circles and the square in the en-face images increased, the postoperative BCVA significantly increased (r = 0.645, p < 0.001; r = 0.590, p < 0.001, respectively).
CONCLUSIONS
As the nonadhesive surfaces of the epiretinal membrane and the retina in preoperative en face images became wider, the increments of the BCVA after surgery were greater. Therefore, en face optical coherence tomography can be used to predict prognosis after epiretinal membrane peeling.

Keyword

En face image; Epiretinal membrane; Optical coherence tomography

MeSH Terms

Epiretinal Membrane*
Humans
Medical Records
Prognosis*
Retina
Retinaldehyde
Retrospective Studies
Tomography, Optical Coherence*
Visual Acuity
Retinaldehyde

Figure

• 

  Figure 1. Four types of En Face optical coherence tomography (OCT) images. 6,000 × 6,000 qm square (A), 6,000 qm diameter circle (B), 3,000 qm diameter circle (C), and 1,000 qm diameter circle (D). The original En Face OCT image (A) was edited in three circles according to the early treatment diabetic retinopathy study subfields. Then we obtained the black pixel values of each of the images.

• 

  Figure 2. Large area of elevated epiretinal membrane (ERM) peeling. Line scanning ophthalmoscope image (A) and En Face image (B). Black pixelated areas calculated automatically reveal elevated ERM in (B). It shows that the retina and the ERM have a wide area of contact in (A). And the larger the area of contact, the lower the black pixel value may be considered as shown as the narrow area of black color in (B).

• 

  Figure 3. Small area of elevated epiretinal membrane (ERM) peeling. Line scanning ophthalmoscope image (A), and En Face image (B). It shows that the retina and the ERM have a narrow are of contact in (A). And the narrower the area of contact, the greater the black pixel value may be considered as shown as the greater area of black color in (B).

• 

  Figure 4. Scattergram showing the significant positive correlation between the change in best corrected visual acuity (BCVA) and preoperative epiretinal membrane area (pixels) with no retinal contact. (A) BCVA and 6,000 × 6,000 μm square (r = 0.645,p < 0.001), and (B) BCVA and 6,000 μm diameter circle (r = 0.590, p < 0.001).

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