Retinal layers thickness changes following epiretinal membrane surgery

• Published in: Eye (London) Vol. 32; no. 3; pp. 555 - 562
• Main Authors: Hecht, I, Yeshurun, I, Bartov, E, Bar, A, Burgansky-Eliash, Z, Achiron, A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-03-2018; Nature Publishing Group
• Subjects: 692/308/409; 692/698/1688/512/2613/1786; 692/699/3161/3175; Aged; Aged, 80 and over; Case-Control Studies; Clinical Study; Epiretinal Membrane - pathology; Epiretinal Membrane - surgery; Eye; Female; Humans; Image processing; Laboratory Medicine; Macula Lutea - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Nerve Fibers - pathology; Ophthalmology; Pharmaceutical Sciences/Technology; Retina; Retina - pathology; Retinal Ganglion Cells - pathology; Retrospective Studies; Surgery; Surgical Oncology; Tomography, Optical Coherence - methods; Visual Acuity
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2017.233

Purpose
To evaluate the time course of changes in the thickness of retinal layers after epiretinal membrane (ERM) removal surgery.
Methods
A retrospective cohort study of patients following surgery for idiopathic ERM. We used new specialized image analysis software to create a thickness map of each retinal layer and analyzed changes during one year follow-up. Healthy fellow eyes were used as negative controls and the retina prior to surgery as positive control.
Results
Twenty-one patients were included with a mean age of 68±13 years. Central macular thickness decreased steadily until 6 months after surgery (25% decrease, 516±76 to 386±73
 μ
m,
P
<0.001) with no further decrease between 6 and 12 months (386±73 to 390±73
 μ
m,
P
=0.291). The retinal nerve fiber layer (RNFL), and the ganglion cell and inner plexiform layer (GCIPL) were most affected (57%,
P
<0.001 and 27%,
P
=0.010, respectively). The thickest region showed a more abrupt decrease of 21% at first follow-up (504±61 to 399±58
 μ
m,
P
=0.001) with subsequent decrements of about 3%. Prior to surgery all retinal layers were thicker in study eyes compared with healthy control eyes (6–63%, all
P
<0.05).
Conclusions
Following ERM surgery, in the course of 6 months, the macula gradually becomes thinner after which a stable state is reached. All layers appear to be affected, with the RNFL and GCIPL impacted the most. Our results provide a unique view on how the thickness of different retinal layers changes following ERM surgery.