Correlation of foveal photoreceptor integrity with visual outcome in idiopathic epiretinal membrane.

PURPOSE

To evaluate the correlation of foveal photoreceptor integrity with visual outcome in patients undergoing idiopathic epiretinal membrane (ERM) surgery using spectral domain optical coherence tomography (SD-OCT).

MATERIALS AND METHODS

Forty-three eyes of 43 patients were examined by SD-OCT before and at 1 and 6 months after vitrectomy for idiopathic ERM. Patients were divided into two groups based on the preoperative integrity of photoreceptor inner and outer segment junction (IS/OS) - Group I, intact IS/OS and Group D, disrupted IS/OS. Where present, disrupted length of IS/OS was measured, and the association between disrupted length of IS/OS and foveal thickness with best corrected visual acuity (BCVA) was evaluated.

RESULTS

There were 27 eyes with an intact IS/OS (Group I) and 16 eyes with a disrupted IS/OS (Group D). Patients in Group I had significantly better postoperative BCVA and greater improvement than those in Group D at 6 months after surgery (p = 0.001 and p = 0.030, respectively). By 6 months after surgery, the disrupted length of IS/OS observed preoperatively in Group D had decreased significantly (p = 0.007). The disrupted length of IS/OS before and at 6 months after the surgery in Group D showed a positive correlation with BCVA (r = 0.632 and p = 0.009; r = 0.658 and p = 0.006, respectively). Foveal thickness did not correlate significantly with preoperative and postoperative BCVA.

CONCLUSIONS

Preoperative disruption of foveal photoreceptors can be restored after ERM surgery. The preoperative integrity of foveal photoreceptors may be a clinically significant prognostic factor for visual recovery in patients with idiopathic ERM.