SCIENTIFIC POSTER

Functional and Morphological Results of Epiretinal Membrane Surgery in Idiopathic Versus Diabetic Epiretinal Membranes by Mine Ozturk, Dilek Guven, Mehmet Demir, Hakan Kacar, Murat Karapapak, Turkey


ABSTRACT

Purpose:

Idiopathic and diabetic epiretinal membranes (ERM) are different in the terms of etiology and macular morphology and may respond to surgical treatment differently. Our aim was to compare the changes of morphology and best corrected visual acuity (BCVA) after surgery in diabetic and idiopathic ERMs.

Methods:

This was a retrospective case series study of 71 eyes of 67 patients who underwent pars plana vitrectomy (PPV) due to idiopathic and diabetic ERM with at least 1 year of follow-up. Examinations were performed before, and 1, 3, 6, and 12 months after surgery. The average macular thicknesses in nine sectors described by the Early Treatment Diabetic Retinopathy Study (CFK=central foveal thickness, Si=superior inner, ni=nazal inner, ti=temporal inner, ii=inferior inner, so=superior outer, to=temporal outer, no=nazal outer, io=inferior outer were measured with spectral-domain optical coherence tomography (OCT) and BCVA was evaluated. Also ERM recurrence rates were investigated.

Results:

This study included 71 eyes of 66 patients. The patients were 35 males (%53) and 31 females (%47) with an average age of 67.4 ± 9,0 years (min=32 max=88). In the idiopathic ERM group, there were 34 eyes of 32 patients. In this group there were 14 male and 18 female patients. The main age of the patients was 65.7±9.8 years (range: 32-78). In the diabetic ERM group, there were 37 eyes of 34 patients. In this group there were 18 male and 16 female patients. The mean age of the patients was 68.9±8 years (range: 54-88 ). Pars plana vitrectomy with membrane peeling was the main surgical treatment. ILM peeling was performed in 48 eyes (%68.6) in total group. ERM recurrence was observed in 9 eyes (%12.7) ;3 eyes with ILM peeling and 6 eyes without ILM peeling (p=0.041). In idiopatic group, ILM peeling was performed in 20 eyes (%58.8). ERM recurrence was seen in 3 eyes (%21.4) of the eyes without ILM peeling while there was no recurrence in the eyes with ILM peeling (p=0.050). In diabetic group, ILM peeling was performed in 28 eyes (%75.7). ERM recurrence was seen in 3 eyes (%33.3) of the eyes without ILM peeling and in 3 eyes (%10.7) of the eyes with ILM peeling (p=0.130). BCVA was better in the idiopathic group than in the diabetic group in all visits, but changes in BCVA was similar between two groups compared in different visits. For both groups, change in BCVA was not statistically significant between preop – first month and third – sixth month visits’ values. For both groups, BCVA improved significantly (pË‚0,001) 12 months postoperatively. RT in all sectors decreased significantly in both groups after 12 months compared with preoperative measurements. In the comparison of the preoperative and first months’ values, there was a significant decrease in all sectors in the diabetic group, while there was no significant decrease in io and no sectors in the idiopathic group. For the first and third month measurements, there was a significant decrease in all sectors except ii sector in the idiopathic group while only si, ti and io sectors showed significant decrease in the diabetic group. After 3 months, change in the retinal thickness decreased. Only so and no sectors showed significant decrease in the idiopathic group in the comparison of the third and sixth months, while there was no difference in the diabetic group. Within the period of the sixth and twelfth months, there was significant decrease only in the diabetic group as in ti, ni, so and no sectors. In conclusion, for the idiopathic group, most of the significant changes in retinal thickness occured within the first 6 months. In the diabetic group, significant retinal thickness changes occured within the first three months, slowed down in the second three months and accelerated again in the last six months.

Conclusions:

In both idiopathic and diabetic groups, retinal thickness changes occurred as long as 12 months after vitrectomy surgery for ERM. However, in the idiopathic group, significant changes are mainly seen in the first six months, while in the diabetic group changes slowed between the 3rd and 6th months considerably, but again accelerated the last 6 months to be significant. According to the findings of this study, as compared to those with idiopathic retinopathy, diabetic patients may see continuing benefits from ERM surgery 6 to 12 months post surgery. BCVA changes of two groups were similar. ILM peeling decreased ERM recurrence in the idiopathic group but not in the diabetic group.


CONTACT DETAILS

Mine Ozturk, Dilek Guven, Mehmet Demir, Hakan Kacar, Murat Karapapak
Haseki Education and Research Hospital
Istanbul
Turkey
Email : dr_mine@yahoo.com
Cell Phone: +905324115355
Work Phone: +902125294400