Assessment of outcomes of idiopathic macular epiretinal membrane based on preoperative classification of the epiretinal membrane with OCT / 眼科新进展

ABSTRACT

Objective To classify idiopathic macular epiretinal membrane (IMEM) on the basis of OCT and its application value in predicting visual acuity of patients after operation.Methods Totally 29 patients (30 eyes) with IMEM admitted in Shenzhen Eye Hospital from February 2013 to May 2016 were included in this study and divided into 4 levels based on the morphologic change of macular fovea by preoperative OCT examination.All the patients were given minimally invasive vitrectomy for stripping macular epiretinal membrane (MEM),and examined for best corrected visual acuity (BCVA) and central foveal thickness (CFT) 6 months after surgery.Results As the grading increased,the patient's macular foveal became disorganized,the appearance of the macular membrane was presented and the loss of macular foveal was more obvious.There was significant difference between preoperative and postoperative LogMAR BCVA (all P ＜ 0.01).Preoperative and postoperative LogMAR BCVA was increased with the grading,and the difference was statistically significant (all P ＜ 0.05),suggesting that patients with high-level epiretinal membranes suffered from poor visual acuity.The difference between preoperative and postoperative LogMAR BCVA was the largest in patients with grade Ⅱ idiopathic macular degeneration,and the difference was statistically significant compared with other levels (all P ＜ 0.001).It is suggested that BCVA of grade Ⅱ patients has the greatest improvement after operation.Apart from grade Ⅲ patients,there was no significant difference in CFT among the patients with other levels before and after operation (all P ＞ 0.05).The preoperative and postoperative CFTs between patients were increased with the grading,and the differences were statistically significant (all P ＜ 0.001),suggesting that the higher the level was,the larger the macular thickness.Conclusion The classification of IMEM based on OCT examination images not only helps to predict the postoperative visual acuity and CFT recovery but also the timing of operation in patients with idiopathic macular degeneration.