ABSTRACT

Purpose:

To analyze the changes in macular architecture after ERM (epiretinal membrane) and ILM (inner limiting membrane) peeling using the automated layer segmentation of the Spectralis OCT (Heidelberg Engineering) and to correlate the findings with the visual improvement after surgery.

Methods:

Retrospectively, the SD-OCT- data of 30 eyes that underwent pars plana surgery with ERM and ILM peeling were segmented and analyzed: preoperatively, 3 month and 6 months postoperatively. Additionally the data of 10 matched control eyes was analyzed. The volume and the maximal thickness of all layers of the central parafoveal area (10°) were measured. Functional parameters as the BCVA (best-corrected visual acuity) and the assessment of metamorphopsia (Amsler-test) were correlated with these findings.

Results:

The BCVA improved from 0,44 preoperatively to 0,15 logMAR at 6 months, the metamorphopsia decreased in 78%. The automated segmentation had to be corrected manually in 80% of the cases. The preoperative layers, which were most severely affected by deformation, were the INL (inner nuclear layer) and the IPL (inner plexiforme layer) (difference to controls p<0,001). The postoperative reorganization was most pronounced in the IPL, INL and the OPL (outer plexiforme layer) in volume and the INL and the ONL (outer nuclear layer) in max. thickness (p<0,01). The decrease of the volume and the max. thickness of the total retina, the INL and IPL had a strong correlation to the BCVA (Pearson correlation). The metamorphopsia correlated with the INL, OPL and ONL.

Conclusions:

The automated segmentation of the parafoveal layers of the retina enables a precise analysis of the reorganization of the retinal architecture. The visual function could be correlated with the changes of the ILM, IPL and the ONL.


CONTACT DETAILS

Burkhard von Jagow
Schlosspark-Klinik
Berlin
Germany
Email : burkhardvjagow@gmail.com
Cell Phone: +491776336968
Work Phone: +493032641931