Surgery for idiopathic epiretinal membrane.
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ABSTRACT:
SUBMITTER: Yusuf AM
PROVIDER: S-EPMC8095007 | biostudies-literature | 2021 Mar
REPOSITORIES: biostudies-literature
Publications
Surgery for idiopathic epiretinal membrane.
Yusuf Ammar M AM Bizrah Mukhtar M Bunce Catey C Bainbridge James W JW
The Cochrane database of systematic reviews 20210324
<h4>Background</h4>Epiretinal membrane is an abnormal sheet of avascular fibrocellular tissue that develops on the inner surface of the retina. Epiretinal membrane can cause impairment of sight as a consequence of progressive distortion of retinal architecture.<h4>Objectives</h4>To determine the effects of surgery compared to no intervention for epiretinal membrane.<h4>Search methods</h4>We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, ISRCTN r ...[more]
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Project description:BackgroundAlthough previously published meta-analyses have compared the surgical effects between the methods of Idiopathic epiretinal membrane (iERM) removal with or without ILM peeling, they did not reach an agreement.PurposeWe aimed to provide more evidence for the treatment of iERM and whether additional ILM peeling was better or not by analyzing more updated studies and randomized control trials (RCTs).MethodThe search was conducted in Pubmed, Embase, Cochrane Library, Web of Science and Open Grey without language limitation and the studies included were from inception to December 2019. All studies of iERM with or without ILM peeling showed at least one of outcomes, such as best-corrected visual acuity (BCVA), central macular thickness (CMT) and recurrence of ERM. The pooled results between above groups were showed by the mean differences (MDs) and risk ratios (RR) with corresponding 95% confidence intervals (CIs).ResultIn total, 1645 eyes of five randomized controlled trials (RCTs) and fifteen retrospective studies were included. The short-term (<12 months) BCVA improvement in both groups showed no significant difference (MD = -0.01; 95% CI = -0.02 to 0.01; P = 0.36). However, the BCVA improvement was significantly better in ILM peeling eyes than in those without ILM peeling when considering the risk bias (MD = -0.04; 95% CI = -0.07 to -0.01; P = 0.008). The short-term (<12 months) CMT had a higher reduction in non ILM peeling group (MD = -9.02; 95% CI = -12.51 to -5.54; P < 0.00001) and the recurrence of ERM in ILM peeling group was lower (P < 0.00001). The long-term (≥12months) BCVA improvement ((MD = -0.00; 95% CI = -0.03 to 0.03; P = 0.97) and reduction of long-term (≥12months) CMT (MD = -1.14; 95% CI = -7.14 to -4.86; P = 0.71) were similar in both groups.ConclusionBy considering the risk of bias, we should determine whether ILM peeling is beneficial for short-term changes in BCVA in patients with iERM. Nevertheless, further studies are needed to confirm this. iERM removal without ILM peeling can improve the short-term decrease in CMT and ILM peeling decreases the recurrence of ERM, but the long-term changes in BCVA and CMT are similar with or without ILM peeling. There is a need for a true large scale randomized trial that will also include microperimetry and other functional measures.
| S-EPMC7815136 | biostudies-literature
Project description:Purpose: To explore the surgical outcomes of the macular microvasculature and visual function in eyes with idiopathic epiretinal membrane (iERM) using spectral-domain optical coherence tomography angiography (SD-OCTA). Methods: This observational, cross-sectional study included 41 participants who underwent iERM surgery with a 3-month (3M) follow-up. Forty-one healthy eyes formed the control group. The assessments included best-corrected visual acuity (BCVA) and mean sensitivity (MS) by microperimetry and SD-OCTA assessment of vessel tortuosity (VT), vessel density (VD), foveal avascular zone, and retinal thickness (RT). Results: The findings showed statistically significant differences in VT, foveal avascular zone parameters, RT, BCVA, and MS between the iERM and control groups (p < 0.05). After iERM surgery, the macular VT, SCP VD, and RT decreased significantly (p < 0.01) while the DCP VD increased (p = 0.029). The BCVA improved significantly (p < 0.001) and was associated with the MS (rs = -0.377, p = 0.015). MS was associated with the SCP VD and RT at 3M (SCP VD rs = 0.511, p = 0.001; RT rs = 0.456, p = 0.003). In the superior quadrant, the MS improved significantly (p < 0.001) and the improvement of MS was associated with the reduction of VT (β = -0.330, p = 0.034). Conclusion: Microcirculatory remodeling and perfusion recovery were observed within 3 months after iERM surgery. VT was a novel index for evaluating the morphology of the retinal microvasculature in eyes with iERM and was associated with MS in the superior quadrant.
| S-EPMC10156972 | biostudies-literature
Project description:To determine the characteristics of the changes in the amplitude of the flicker electroretinograms (ERGs) after combined cataract surgery and vitrectomy for an idiopathic epiretinal membrane (ERM). To accomplish this, we conducted a prospective study on 20 patients. Flicker ERGs and central macular thickness (CMT) were measured before the surgery (baseline), and at 1 week, 1 month, 3 months, and 6 months postoperatively. The mean amplitude of the flicker ERGs increased significantly by 63.5% at 1 week after surgery (P < 0.001) and then gradually decreased. The amplitude at 6 months was not significantly different from the baseline amplitude. This transient increase in the flicker ERG amplitudes after ERM surgery suggests that electrophysiologic evaluations of the therapeutic effects of vitrectomy should be performed 6 months postoperatively. The mean CMT decreased significantly at 1 week postoperatively (P < 0.001) and continued to decrease progressively over six months. The relative increase of amplitude at 1 week was significantly associated with the relative decrease of CMT at 6 months, and evaluation of retinal functional changes at 1 week may be able to predict the postoperative course of the ERM.
| S-EPMC11464553 | biostudies-literature
Project description:PurposeTo investigate the relationship between ophthalmic parameters-including optical coherence tomography (OCT) and OCT angiography findings-and foveal pit restoration in eyes that had undergone vitrectomy for idiopathic epiretinal membrane (iERM) removal.MethodsThis study retrospectively analyzed data of patients who underwent pars planar vitrectomy for the removal of epirentinal membrane. Only eyes with iERM above stage 2 with a follow-up over 6 months were included. Baseline data and changes in ophthalmic parameters were analyzed from 3 months before to 12 months after surgery. Additionally, we stratified iERM patients into two groups (foveal pit restoration and no restoration group). Longitudinal comparison analyses between the two groups were done in best-corrected visual acuity (BCVA), central foveal thickness (CFT) and foveal avascular zone (FAZ) areas measurements using swept-source OCT and OCT angiography.ResultsForty-three patients with a mean age of 75 ± 5 years were enrolled. After surgery, BCVA, FAZ, and CFT showed improvements over time (all p < 0.002). Thirty-one patients were designated into the foveal pit restoration (R) group and 12 patients into the no restoration (NR) group. Differences in BCVA and FAZ area in both groups existed up to 6 months. However, BCVA improved and FAZ expanded (R, 0.20 ± 0.05 vs. NR, 0.18 ± 0.04) in both groups showing no statistical difference 12 months postsurgery. The CFT decreased in both groups, but the R group was thinner at every point compared to the NR group (all p < 0.05).ConclusionsThe removal of epirentinal membrane in pars planar vitrectomy significantly improves BCVA, decreases the CFT and expands the FAZ. Foveal pit restoration improves BCVA, CFT, and FAZ area possibly at a faster rate in the early months but long-term improvements could be achieved regardless of the status of foveal pit restoration.
| S-EPMC8849990 | biostudies-literature
Project description:PurposeTo further evaluate the necessity of internal limiting membrane (ILM) peeling for patients with idiopathic epiretinal membrane (iERM).MethodWe searched PubMed, Web of Science, Embase, Cochrane Library, and CNKI from their inception up to August 24, 2021. Eligible meta-analyses comparing iERM removal with and without ILM peeling were included. AMSTAR and GRADE classification was used to assess the methodological quality of each study and the quality for each outcome, respectively. The primary outcomes were best-corrected visual acuity (BCVA), central macular thickness (CMT), and recurrence.Results10 meta-analyses were included. 75.9% of studies revealed no statistically significant difference in BCVA between the groups, while only 10.3% showed better BCVA favorable to additional ILM peeling. 54.2% reported no significant difference in CMT between the groups, followed by 41.7% showing thicker CMT due to additional ILM peeling. Compared to iERM removal alone, additional ILM peeling provided a lower recurrence rate in 66.7% of studies.ConclusionILM peeling could significantly reduce recurrence rate, but not significantly improve the recovery of visual outcome or decrease the thickness of central macula.
| S-EPMC10006490 | biostudies-literature
Project description:PurposeTo introduce a novel method to quantitively analyse in three dimensions traction forces in a vast area of the ocular posterior pole.MethodsRetrospective analysis of 14 eyes who underwent peeling surgery for idiopathic, symptomatic and progressive epiretinal membrane. The technique measures the shift in position of vascular crossings after surgery from a fixed point, which is the retinal pigmented epithelium. This shift is defined as the relaxation index (RI) and represents a measure of the postoperative movement of the retina due to released traction after surgery.ResultsBest-corrected visual acuity was significantly better than baseline at all follow ups while the RI had its maximum value at baseline. Moreover, we found a significant correlation between best-corrected visual acuity at 6 months and RI at baseline.ConclusionWhile all previous published methods focused on bi-dimensional changes observed in a small region, this study introduces a three-dimensional assessment of tractional forces. Future integration of RI into built-in processing software will allow systematic three-dimensional measurement of intraretinal traction.
| S-EPMC7968655 | biostudies-literature
Project description:We compared the proteome of epiretinal membrane of iERM with the proteome of the inner limiting membrane (ILM) of idiopathic macular hole (iMH). Twelve epiretinal membrane samples from iERM were compared with twelve ILM samples obtained from from iMH. Proteomic analysis was conducted with LFQ nLC-MS/MS. Discovery data were searched against the Uniprot Homo sapiens protein database using MaxQuant.
2019-07-18 | PXD014286 | Pride
Project description:We report intensely staining epiretinal membrane (ERM) with Brilliant Blue G (BBG) under air for two minutes. ERM peeling was performed in 21 cases. After removal of posterior hyaloid, 0.2 mL BBG was first applied on the macula, to stain ERM under air conditions for 2 minutes. Internal limiting membrane (ILM) was intensely stained and peeled in all cases following ERM removal. In 4 cases, the ERM was also observed to be intensely stained with BBG and peeled with an ILM forceps. Postoperatively, the ganglion cell layer thickness was lower in three of the cases, however VA improved in all cases and multifocal electroretinogram revealed no toxicity. Light microscopy of ERM revealed masses of cells whereas; the ILM did not. The increased staining characteristics of ERM and ILM may be resulted from longer contact time of BBG under air pressure.
| S-EPMC3918925 | biostudies-literature
Project description:PurposeTo assess the rate and risk factors of cystoid macular edema (CME) both after isolated vitrectomy and after subsequent phacoemulsification in eyes with primary noncomplicated rhegmatogenous retinal detachment (RRD) or idiopathic epiretinal membrane (ERM).MethodsRetrospective observation of institutional patients undergoing vitrectomy for RRD or vitrectomy with internal limiting membrane peeling for ERM from 2016 to 2021, further analyzing those who later underwent phacoemulsification. The CME rate was assessed within the first 6 months after both vitrectomy and cataract surgery.ResultsThe authors included 187 phakic eyes with ERM and 311 with RRD undergoing isolated vitrectomy. Postvitrectomy CME occurred in 12.8% of ERM cases compared with 1% in RRD cases ( P < 0.0001). Stage-4 ERMs and intraoperative laser were found associated with CME. After uncomplicated phacoemulsification, the CME rate was higher in eyes vitrectomized for ERM (13.8%) compared with RRD (2%, P = 0.0055). Postvitrectomy CME was found to be associated with an increased risk of postcataract CME (odds ratio 13.588, P = 0.0187).ConclusionIn eyes undergoing phacoemulsification postvitrectomy, the risk of CME is higher when vitrectomy was performed for ERM compared with RRD. The ERM-related intraretinal changes, together with the required surgical stress, may play a role in making these eyes more susceptible to CME.
| S-EPMC11753465 | biostudies-literature
Project description:PURPOSE:To examine the foveal structure and vasculature in eyes with an idiopathic epiretinal membrane (ERM). METHODS:Forty-nine eyes of 48 patients with an idiopathic ERM were studied. The superficial foveal avascular zone (FAZ) was measured by optical coherence tomography angiography (OCTA; RTVue XR Avanti, Optovue Inc., Fremont, CA), and the central foveal thickness (CFT) was measured by swept source OCT (DRI-OCT, Topcon, Japan). Twenty eyes underwent vitrectomy with internal limiting membrane (ILM) peeling, and the FAZ and CFT were evaluated pre- and postoperatively. Forty-nine eyes of 49 age-matched healthy subjects were also examined as control. RESULTS:The FAZ in eyes with an ERM was significantly smaller than that of the control eyes (0.188±0.16 mm2 vs 0.328±0.14 mm2, P<0.01). The CFT in eyes with an ERM was significantly thicker than that of control eyes (315±0.14 μm vs 193±0.14 μm, P<0.01). The size of the FAZ was strongly correlated with the CFT (ERM, R = -0.753; control, R = -0.61, both P<0.01). The postoperative size of the FAZ was not significantly different from the preoperative size (0.115 mm2 vs 0.128 mm2, P = 0.17) but the CFT was significantly thinner (370 μm vs 288 μm, P<0.01) after the vitrectomy with ILM peeling in 20 eyes. CONCLUSIONS:The results indicate that an ERM might affect the morphology and vasculature of not only the inner but also the outer retina before and after vitrectomy with ILM peeling. The FAZ area might have been affected by the ILM peeling.
| S-EPMC6445520 | biostudies-literature