J Korean Ophthalmol Soc.  2017 Apr;58(4):420-429. 10.3341/jkos.2017.58.4.420.

The Thickness of Each Retinal Layer and Visual Acuity after Vitrectomy in Idiopathic Epiretinal Membrane

• Kim MH
• Jeon CY
• Baek SK
• Chang YS
• Lee YH

• KMID: 2376597
• DOI: http://doi.org/10.3341/jkos.2017.58.4.420

Abstract

PURPOSE
In this study, we evaluated the thickness of each retinal layer using spectral-domain optical coherence tomography (OCT) and investigated the correlation between the thickness of each retinal layer and postoperative visual acuity in eyes with idiopathic epiretinal membrane (ERM).
METHODS
This retrospective study included 46 eyes from 46 patients with idiopathic ERM who underwent pars plana vitrectomy. Each retinal layer thickness was measured by spectral-domain OCT before operation and at 1, 3, and 6 months after operation. The thickness of each retinal layer was evaluated in the control group before the operation. We performed an analysis of the changes in thickness of each retinal layer at 6 months after operation and then investigated the correlation between the retinal layer thickness and visual improvement.
RESULTS
Preoperatively, the thickness of the retinal nerve fiber layer (RNFL) in the ERM group showed more increased compared with that in the control group, and the thickness of photoreceptors and retinal pigment epithelium were decreased compared to those in the control group. At 6 months after the operation, thickness changes were reduced at the RNFL, ganglion cell layer (GCL), inner plexiform layer (IPL), GCL-IPL complex, and outer plexiform layer, while the photoreceptor layer increased compared with the values preoperatively. Differences in the preoperative thickness of GCL between the two groups had a significant correlation with postoperative visual acuity (r = 0.477, p = 0.008).
CONCLUSIONS
Differences in preoperative thickness of the GCL between the two groups had a significant correlation with postoperative visual acuity. The greater was the thickness of the GCL, the worse was the visual outcome.

Keyword

Idiopathic epiretinal membrane; Pars plana vitrectomy; Retinal layer thickness; Visual acuity

MeSH Terms

Epiretinal Membrane*
Ganglion Cysts
Humans
Nerve Fibers
Retinal Pigment Epithelium
Retinaldehyde*
Retrospective Studies
Tomography, Optical Coherence
Visual Acuity*
Vitrectomy*
Retinaldehyde

Figure

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  Figure 1. Representative image of retinal layer division determined by the new segmentation application of the spectralis optical coherence tomography in epiretinal membrane (Segmentation Technology; Heidelberg Engineering, Inc., Heidelberg, Germany). 10 layers: 1 = inner limiting membrane, 2 = retinal nerve fiber layer, 3 = ganglion cell layer, 4 = inner plexiform layer, 5 = inner nuclear layer, 6 = outer plexiform layer, 7 = external limiting membrane, 8 = photoreceptor, 9 = retinal pigment epithelium, 10 = Bruch's membrane.

• 

  Figure 2. Early Treatment of Diabetic Retinopathy Study (ETDRS) subfield. Central circle: fovea (F). Inner ring: superior inner (SI) + nasal inner (NI) + inferior inner (II) + temporal inner (TI). Outer ring: superior outer (SO) + nasal outer (NO) + inferior outer (IO) + temporal outer (TO). ETDRS subfields within standard 1-, 3-, and 6-mm-diameter concentric circles at the right used for reporting retinal thickness.

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  Figure 3. Longitudinal changes of the average foveal thick-ness of each retinal layer before and after epiretinal membrane surgery. RNFL =retinal nerve fiber layer; GCL =ganglion cell layer; IPL =inner plexiform layer; INL =inner nuclear layer; OPL =outer plexiform layer; ONL =outer nuclear lay-er; PRL = photoreceptor; RPE = retinal pigment epithelium.

Reference

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