Optical coherence tomography [OCT] as a prognostic tool before removal of idiopathic epimacular membrane [EMM]

ABSTRACT

Idiopathic Epimacular Membrane [macular pucker] is a mild manifestation of proliferative vitreo-retinopathic spectrum of disease. It is termed idiopathic if it happened in eyes without any previous ocular diseases. Surgery of Idiopathic EMM has been a common vitreo-retinal disease for many years, and several prognostic factors have been implicated in each removal. With the advance of Optical Coherence Tomography [OCT], it provides us with a detailed cross sectional study of the vitreo-retinal juncture and it is used as a well efficient prognostic tool, that we are aiming for evaluating its efficacy in this study. A prospective study including 30 eyes of Idiopathic EMM were included in this study. All the membranes were removed by standard 3-port vitrectomy with peeling of the EMM by diamond dusted needle. Best corrected visual acuity and standard OCT for the macula were done pre and post operatively 3 months after surgery. Among the 30 eyes that were included in this study, 18 were males [60%] and 12 were females [40%] with an age average of 48-72 with a mean of 61.4. There was a clinically significant improvement in best corrected visual acuity pre and post-operatively [as P=.957] and also there was a clinically significant improvement with the central foveal thickness by OCT on pre and post-operatively [as P=.878]. 6 eyes [20%] got a vision of 20/20 post-operatively and 25 eyes [83.33%] showed improvement than the pre-operative level. Also, all eyes [100%] showed improvement in their CFT, but none of them regained the normal foveal configuration. So, there is no positive correlation found between the best corrected visual acuity and the central foveal thickness, either pre-operative or post-operative. OCT is of great value and importance in detecting the abnormal vitreo-retinal relation, and also, in detecting the secondary effect on the underlying retina, like spaces, pseudohole, or even true hole formation with EMM formation which are more important than the thickness by itself before surgical removal of epimacular membrane