Retinal relaxation following membrane peeling: Effect on vision, central macular thickness, and vector analysis of motion.

Epiretinal membrane internal limiting membrane optical coherence tomography relaxation scanning laser ophthalmoscopy surgery vector analysis

Journal

Journal of clinical and translational research
ISSN: 2424-810X
Titre abrégé: J Clin Transl Res
Pays: Singapore
ID NLM: 101667205

Informations de publication

Date de publication:
09 Jun 2020
Historique:
received: 12 01 2020
revised: 09 04 2020
accepted: 09 04 2020
entrez: 8 10 2020
pubmed: 9 10 2020
medline: 9 10 2020
Statut: epublish

Résumé

Epiretinal membranes (ERM) form as a result of an inward displacement of retinal structures. Removal of an ERM leads to the outward displacement of retinal vessels and visual improvement. The aim of the study was to evaluate the direction and extent of displacement of retinal/superficial vascular structures after a membrane peeling procedure by means of image comparison and in selected cases, a vector analysis of displacement. Scanning laser ophthalmoscope images of the retina of eyes undergoing ERM peeling were compared before and 6 months after surgery. Stratification was made between prominent and limited displacement, with assessment of visual acuity (VA), and central macular thickness (CMT). In three cases, using the optic nerve as reference, 50 landmarks were chosen within the posterior pole along large and small vascular structures allowing the construction of a vector map of displacement over 1 year. Nine eyes with prominent and six with limited displacement were assessed. Improvement in VA was similar for both groups, while CMT drop was greatest for the worst group. Vector analysis showed that most vascular movement occurs over the first 6 months, covers most of the posterior retina, is centered around distinct nodes, and may lead to several hundred micrometers of displacement. Superficial retinal relaxation has no direct implication on visual recovery. It originates in nodes of retinal contraction. Its extent can be significant, covering most of the posterior pole. A better understanding of retinal relaxation following the peeling of ERM may help better understand when intervention is required and which part of the membrane is critical to surgical success.

Sections du résumé

BACKGROUND BACKGROUND
Epiretinal membranes (ERM) form as a result of an inward displacement of retinal structures. Removal of an ERM leads to the outward displacement of retinal vessels and visual improvement.
PURPOSE OBJECTIVE
The aim of the study was to evaluate the direction and extent of displacement of retinal/superficial vascular structures after a membrane peeling procedure by means of image comparison and in selected cases, a vector analysis of displacement.
METHODOLOGY METHODS
Scanning laser ophthalmoscope images of the retina of eyes undergoing ERM peeling were compared before and 6 months after surgery. Stratification was made between prominent and limited displacement, with assessment of visual acuity (VA), and central macular thickness (CMT). In three cases, using the optic nerve as reference, 50 landmarks were chosen within the posterior pole along large and small vascular structures allowing the construction of a vector map of displacement over 1 year.
RESULTS RESULTS
Nine eyes with prominent and six with limited displacement were assessed. Improvement in VA was similar for both groups, while CMT drop was greatest for the worst group. Vector analysis showed that most vascular movement occurs over the first 6 months, covers most of the posterior retina, is centered around distinct nodes, and may lead to several hundred micrometers of displacement.
CONCLUSIONS CONCLUSIONS
Superficial retinal relaxation has no direct implication on visual recovery. It originates in nodes of retinal contraction. Its extent can be significant, covering most of the posterior pole.
RELEVANCE FOR PATIENTS UNASSIGNED
A better understanding of retinal relaxation following the peeling of ERM may help better understand when intervention is required and which part of the membrane is critical to surgical success.

Identifiants

pubmed: 33029566
pii: jctres.05.202005.003
pmc: PMC7534668

Types de publication

Journal Article

Langues

eng

Pagination

236-242

Informations de copyright

Copyright: © Whioce Publishing Pte. Ltd.

Déclaration de conflit d'intérêts

The authors declare that they have no conflicts of interest.

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Auteurs

Marc D de Smet (MD)

Micro Invasive Ocular Surgery Center, Lausanne, Switzerland.

Karina Julian (K)

Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.

Jerick Maurin (J)

Micro Invasive Ocular Surgery Center, Lausanne, Switzerland.

Laurent P Jolissaint (LP)

Department of Optical Instrumentation, University of Applied Sciences of Western Switzerland, Yverdon, Switzerland.

Marco Mura (M)

Division of Vitreoretinal Surgery, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

Classifications MeSH