The effect of epiretinal membrane surgery on macular microvasculature: an optical coherence tomography angiography study
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ORIGINAL PAPER
The effect of epiretinal membrane surgery on macular microvasculature: an optical coherence tomography angiography study Puren Isik-Ericek
. Selcuk Sizmaz
. Ebru Esen
. Nihal Demircan
Received: 18 June 2020 / Accepted: 29 October 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To investigate both the possible effects of both idiopathic epiretinal membrane (IERM) itself and surgery on macular microvascular structure using optical coherence tomography angiography (OCT-A) and to determine the associations with structural and visual outcomes. Methods Twenty-four eyes of 24 patients with IERM and 24 eyes of 12 healthy controls were included. Vascular parameters, including the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were evaluated by OCT-A prior to and 6 months after ERM removal. The foveal avascular zone (FAZ, mm2) area, parafoveal vascular density (VD, %) and flow area (mm2) measurements were used to evaluate the macular vascular integrity. Results The mean preoperative vascular density (VD) of both plexuses was lower in eyes with IERM than in healthy eyes (both p = 0.0001). The mean preoperative flow area of the DCP in eyes with IERM
was significantly lower than that in the control eyes (p = 0.016). There was no significant difference in the VD or flow area in either superficial or deep capillary plexuses as a result of surgery (SCP; p = 0.957, p = 0.97, DCP; p = 0.861, p = 0.6, respectively). Both the parafoveal DCP-VD and flow area in DCP were negatively correlated with best-corrected visual acuity (logMAR) at 6 months postoperatively (r = -0.46, p = 0.03; r = -0.52, p = 0.01, respectively). Conclusion Epiretinal membranes may cause dynamic microvascular changes at the macula. However, the effect of surgery on microvasculature may be more limited than that on anatomical and visual recovery. OCT-A may serve as a useful tool in understanding the pathophysiological basis of diseases. Keywords Macular microvasculature Idiopathic epiretinal membrane Optical coherence tomography angiography Vitreoretinal surgery
The Excel data used to support the findings of this study are available from the corresponding author upon request. P. Isik-Ericek (&) Department of Ophthalmology, Nigde Omer Halisdemir University, Nigde 51200, Turkey e-mail: [email protected] S. Sizmaz E. Esen N. Demircan Department of Ophthalmology, Cukurova University School of Medicine, Adana, Turkey
Introduction Epiretinal membrane (ERM) is a translucent, avascular, fibrocellular proliferation along the surface of the internal limiting membrane (ILM). Epiretinal membrane, as a relatively common disorder in the elderly
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population, may cause loss of visual acuity and metamorphopsia, thus impairing vision-related quality of life [1]. ERM is mostly idiopathic and is not associated with ocular pathologies such as uveitis and retinal vascular diseases; otherwise, the condition is called secondary ERM [2]. In histological studies, ER
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