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Published in: BMC Ophthalmology 1/2020

01-12-2020 | Angiography | Research article

A study analyzing macular microvasculature features after vitrectomy using OCT angiography in patients with idiopathic macular epiretinal membrane

Authors: Jianbo Mao, Jimeng Lao, Chenyi Liu, Caiyun Zhang, Yiqi Chen, Jiwei Tao, Lijun Shen

Published in: BMC Ophthalmology | Issue 1/2020

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Abstract

Background

To evaluate postoperative changes in retinal capillary plexus and to assess contributing factors in postoperative visual improvement using optical coherence tomography angiography (OCT-A) in patients with idiopathic epiretinal membrane (iERM) post membrane removal.

Methods

Patients scheduled for vitrectomy and membrane peel for iERM were enrolled. 35 subjects were included for this study. OCT-A was used to measure the FAZ related parameters and the superficial and deep capillary plexus layers using 3 mm × 3 mm scans. Measurements were taken before surgery and at every post-surgical follow-up. The unaffected fellow eyes were used as controls. Evaluated factors included: BCVA, vessel density (VD) and retinal thickness (RT) in five regions, FAZ area, FAZ perimeter (PERIM), acircularity index (AI) and foveal vessel density (FD).

Results

Compared with the control group, the foveal vessel density (FVD) in superficial capillary plexus (SCP) was greater in the epi-retinal membrane group (P < 0.0001), whereas both groups had comparable parafoveal vessel density (PRVD) in SCP (p > 0.05). After surgery there was a reduction in the PRVD in SCP. The FVD in DCP increased and the PRVD in DCP decreased at baseline (p < 0.001). After surgery there was an increase in PRVD in DCP. By 6 months post-op, the PRVD had no statistically significant difference compared with the control group (p > 0.05). D-value of LogMAR BCVA was positively correlated with pre-op LogMAR BCVA (p < 0.0001), FVD in SCP (p < 0.001). It was negatively correlated with FAZ area (P < 0.001) and PERIM (P < 0.05).

Conclusions

Vitrectomy and membrane removal led to the decrease of VD in SCP and the increase of PRVD in DCP. Patients with a more severe iERM may receive greater visual improvement with surgery.

Trial registration

Trial registration number (TRN) and date of registration.
ChiCTR2000031289​, retrospectively registered, 2020.03.26.
Literature
1.
go back to reference Clark A, Balducci N, Pichi F, Veronese C, Morara M, Torrazza C, et al. Swelling of the arcuate nerve fiber layer after internal limiting membrane peeling. Retina. 2012;32(8):1608–13.CrossRef Clark A, Balducci N, Pichi F, Veronese C, Morara M, Torrazza C, et al. Swelling of the arcuate nerve fiber layer after internal limiting membrane peeling. Retina. 2012;32(8):1608–13.CrossRef
2.
go back to reference Scheerlinck LM, van der Valk R, van Leeuwen R. Predictive factors for postoperative visual acuity in idiopathic epiretinal membrane: a systematic review. Acta Ophthalmol. 2015;93(3):203–12.CrossRef Scheerlinck LM, van der Valk R, van Leeuwen R. Predictive factors for postoperative visual acuity in idiopathic epiretinal membrane: a systematic review. Acta Ophthalmol. 2015;93(3):203–12.CrossRef
3.
go back to reference Inoue M, Arakawa A, Yamane S, Kadonosono K. Long-term outcome of preoperative disrupted inner/outer segment junctions assessed using spectral-domain optical coherence tomography in patients with idiopathic epiretinal membrane. Ophthalmologica. 2012;228(4):222–8.CrossRef Inoue M, Arakawa A, Yamane S, Kadonosono K. Long-term outcome of preoperative disrupted inner/outer segment junctions assessed using spectral-domain optical coherence tomography in patients with idiopathic epiretinal membrane. Ophthalmologica. 2012;228(4):222–8.CrossRef
4.
go back to reference Nitta E, Shiraga F, Shiragami C, Fukuda K, Yamashita A, Fujiwara A. Displacement of the retina and its recovery after vitrectomy in idiopathic epiretinal membrane. Am J Ophthalmol. 2013;155(6):1014–20.CrossRef Nitta E, Shiraga F, Shiragami C, Fukuda K, Yamashita A, Fujiwara A. Displacement of the retina and its recovery after vitrectomy in idiopathic epiretinal membrane. Am J Ophthalmol. 2013;155(6):1014–20.CrossRef
5.
go back to reference Liu J, Qian Y, Yang S, Yan L, Wang Y, Gao M, et al. Pathophysiological correlations between fundus fluorescein angiography and optical coherence tomography results in patients with idiopathic epiretinal membranes. Exp Therapeutic Med. 2017;14(6):5785–92. Liu J, Qian Y, Yang S, Yan L, Wang Y, Gao M, et al. Pathophysiological correlations between fundus fluorescein angiography and optical coherence tomography results in patients with idiopathic epiretinal membranes. Exp Therapeutic Med. 2017;14(6):5785–92.
6.
go back to reference Kadonosono K, Itoh N, Nomura E, Ohno S. Capillary blood flow velocity in patients with idiopathic epiretinal membranes. Retina. 1999;19:536–9.CrossRef Kadonosono K, Itoh N, Nomura E, Ohno S. Capillary blood flow velocity in patients with idiopathic epiretinal membranes. Retina. 1999;19:536–9.CrossRef
7.
go back to reference Nelis P, Alten F, Clemens CR, Heiduschka P, Eter N. Quantification of changes in foveal capillary architecture caused by idiopathic epiretinal membrane using OCT angiography. Graefes Arch Clin Exp Ophthalmol. 2017;255:1319–24.CrossRef Nelis P, Alten F, Clemens CR, Heiduschka P, Eter N. Quantification of changes in foveal capillary architecture caused by idiopathic epiretinal membrane using OCT angiography. Graefes Arch Clin Exp Ophthalmol. 2017;255:1319–24.CrossRef
8.
go back to reference Kim YJ, Kim S, Lee JY, Kim JG, Yoon YH. Macular capillary plexuses after epiretinal membrane surgery: an optical coherence tomography angiography study. Br J Ophthalmol. 2018;102(8):1086–91.PubMed Kim YJ, Kim S, Lee JY, Kim JG, Yoon YH. Macular capillary plexuses after epiretinal membrane surgery: an optical coherence tomography angiography study. Br J Ophthalmol. 2018;102(8):1086–91.PubMed
9.
go back to reference Romano MR, Cennamo G, Schiemer S, Rossi C, Sparnelli F, Cennamo G. Deep and superficial OCT angiography changes after macular peeling: idiopathic vs diabetic epiretinal membranes. Graefes Arch Clin Exp Ophthalmol. 2017;255:681–9.CrossRef Romano MR, Cennamo G, Schiemer S, Rossi C, Sparnelli F, Cennamo G. Deep and superficial OCT angiography changes after macular peeling: idiopathic vs diabetic epiretinal membranes. Graefes Arch Clin Exp Ophthalmol. 2017;255:681–9.CrossRef
10.
go back to reference Mastropasqua L, Borrelli E, Carpineto P, Toto L, Di Antonio L, Mattei PA, Mastropasqua R. Microvascular changes after vitrectomy with internal limiting membrane peeling: an optical coherence tomography angiography study. Int Ophthalmol. 2018;38(4):1465–72.CrossRef Mastropasqua L, Borrelli E, Carpineto P, Toto L, Di Antonio L, Mattei PA, Mastropasqua R. Microvascular changes after vitrectomy with internal limiting membrane peeling: an optical coherence tomography angiography study. Int Ophthalmol. 2018;38(4):1465–72.CrossRef
11.
go back to reference Chen H, Chi W, Cai X, Deng Y, Jiang X, Wei Y, et al. Macular microvasculature features before and after vitrectomy in idiopathic macular epiretinal membrane: an OCT angiography analysis. Eye (Lond). 2019;33(4). Chen H, Chi W, Cai X, Deng Y, Jiang X, Wei Y, et al. Macular microvasculature features before and after vitrectomy in idiopathic macular epiretinal membrane: an OCT angiography analysis. Eye (Lond). 2019;33(4).
12.
go back to reference Kitagawa Y, Shimada H, Shinojima A, Nakashizuka H. FOVEAL avascular zone area analysis using optical coherence tomography angiography before and after idiopathic EPIRETINAL membrane surgery. Retina. 2017;0:1–8. Kitagawa Y, Shimada H, Shinojima A, Nakashizuka H. FOVEAL avascular zone area analysis using optical coherence tomography angiography before and after idiopathic EPIRETINAL membrane surgery. Retina. 2017;0:1–8.
13.
go back to reference Kumagai K, Furukawa M, Suetsugu T, Ogino N. Foveal avascular zone area after internal limiting membrane peeling for epiretinal membrane and macular hole compared with that of fellow eyes and healthy controls. Retina. 2018;38(9):1786–94.CrossRef Kumagai K, Furukawa M, Suetsugu T, Ogino N. Foveal avascular zone area after internal limiting membrane peeling for epiretinal membrane and macular hole compared with that of fellow eyes and healthy controls. Retina. 2018;38(9):1786–94.CrossRef
14.
go back to reference Ripandelli G, Scarinci F, Piaggi P, Guidi G, Pileri M, Cupo G, et al. Macular pucker: to peel or not to peel the internal limiting membrane? A microperimetric response. Retina. 2015;35(3):498–507.CrossRef Ripandelli G, Scarinci F, Piaggi P, Guidi G, Pileri M, Cupo G, et al. Macular pucker: to peel or not to peel the internal limiting membrane? A microperimetric response. Retina. 2015;35(3):498–507.CrossRef
15.
go back to reference Kim JH, Kim YM, Chung EJ, Lee SY, Koh HJ. Structural and functional predictors of visual outcome of epiretinal membrane surgery. Am J Ophthalmol. 2012;153:103–10.CrossRef Kim JH, Kim YM, Chung EJ, Lee SY, Koh HJ. Structural and functional predictors of visual outcome of epiretinal membrane surgery. Am J Ophthalmol. 2012;153:103–10.CrossRef
16.
go back to reference Watanabe K, Tsunoda K, Mizuno Y, Akiyama K, Noda T. Outer retinal morphology and visual function in patients with idiopathic epiretinal membrane. JAMA Ophthalmol. 2013;131:172–7.CrossRef Watanabe K, Tsunoda K, Mizuno Y, Akiyama K, Noda T. Outer retinal morphology and visual function in patients with idiopathic epiretinal membrane. JAMA Ophthalmol. 2013;131:172–7.CrossRef
17.
go back to reference Kinoshita T, Kovacs KD, Wagley S, Arroyo JG. Morphologic differences in epiretinal membranes on ocular coherence tomography as a predictive factor for surgical outcome. Retina. 2011;31:1692–8.CrossRef Kinoshita T, Kovacs KD, Wagley S, Arroyo JG. Morphologic differences in epiretinal membranes on ocular coherence tomography as a predictive factor for surgical outcome. Retina. 2011;31:1692–8.CrossRef
18.
go back to reference Lin TC, Chung YC, Lin CY, Lee FL, Chen SJ. Focal nonperfusion of deep retinal capillary plexus in eyes with Epiretinal membranes revealed by optical coherence tomography angiography. Ophthalmic Surg Lasers Imaging Retina. 2016;47:404–9.CrossRef Lin TC, Chung YC, Lin CY, Lee FL, Chen SJ. Focal nonperfusion of deep retinal capillary plexus in eyes with Epiretinal membranes revealed by optical coherence tomography angiography. Ophthalmic Surg Lasers Imaging Retina. 2016;47:404–9.CrossRef
19.
go back to reference Rii T, Itoh Y, Inoue M, Hirota K, Hirakata A. Outer retinal morphological changes and visual function after removal of epiretinal membrane. Can J Ophthalmol. 2014;49:436–42.CrossRef Rii T, Itoh Y, Inoue M, Hirota K, Hirakata A. Outer retinal morphological changes and visual function after removal of epiretinal membrane. Can J Ophthalmol. 2014;49:436–42.CrossRef
20.
go back to reference Gharbiya M, La Cava M, Tortorella P, Abbouda A, Marchiori J, D'Ambrosio E, et al. Peripapillary RNFL thickness changes evaluated with spectral domain optical coherence tomography after uncomplicated macular surgery for Epiretinal membrane. Semin Ophthalmol. 2017;32(4):449–55.CrossRef Gharbiya M, La Cava M, Tortorella P, Abbouda A, Marchiori J, D'Ambrosio E, et al. Peripapillary RNFL thickness changes evaluated with spectral domain optical coherence tomography after uncomplicated macular surgery for Epiretinal membrane. Semin Ophthalmol. 2017;32(4):449–55.CrossRef
21.
go back to reference Zur D, Iglicki M, Feldinger L, Schwartz S, Goldstein M, Loewenstein A, et al. Disorganization of retinal inner layers as a biomarker for idiopathic Epiretinal membrane after macular surgery-the DREAM study. Am J Ophthalmol. 2018;196:129–35.CrossRef Zur D, Iglicki M, Feldinger L, Schwartz S, Goldstein M, Loewenstein A, et al. Disorganization of retinal inner layers as a biomarker for idiopathic Epiretinal membrane after macular surgery-the DREAM study. Am J Ophthalmol. 2018;196:129–35.CrossRef
Metadata
Title
A study analyzing macular microvasculature features after vitrectomy using OCT angiography in patients with idiopathic macular epiretinal membrane
Authors
Jianbo Mao
Jimeng Lao
Chenyi Liu
Caiyun Zhang
Yiqi Chen
Jiwei Tao
Lijun Shen
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2020
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-020-01429-6

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