Aims To investigate macular vascular integrity using optical coherence tomography angiography (OCTA) in patients undergoing vitrectomy for idiopathic epiretinal membrane (ERM) removal and to determine its association with structural and visual outcomes.
Methods Forty-three patients with unilateral ERM who were followed for ≥6 months after surgery were included. Ophthalmological evaluations included best-corrected visual acuity (BCVA) and spectral-domain OCT (SD-OCT) before surgery and 6 months after surgery. We obtained en face OCTA images of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) for both eyes 6 months after ERM removal. We compared eyes with ERM to unaffected fellow eyes as controls and used interocular differences in the analyses.
Results Compared with the fellow eyes, eyes with ERM after surgery had a lower parafoveal vascular density (VD) and a smaller foveal avascular zone (FAZ) area in both SCP and DCP (all p<0.001). Interocular differences in the FAZ area and parafoveal VD were correlated with preoperative and postoperative central foveal thicknesses (all p<0.05). In addition, interocular differences in macular vascular integrity had a tendency to be correlated with SD-OCT parameters of the inner retinal layers. Finally, greater interocular differences in the FAZ area and parafoveal VD of both plexuses were significantly associated with worse postoperative BCVAs (all p<0.05).
Conclusions Assessing macular capillary plexuses via OCTA may be useful to quantify structural changes of the inner retinal layer and predict visual function in patients undergoing ERM removal surgery.
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Contributors All the authors made substantial contributions to this paper. YJK, JYL JGK and YHY participated in the study conception and design and in the critical revision of the article . YJK, SK and YHY participated in the acquisition, analysis and interpretation of data. YJK and YHY participated in the drafting of the article.
Funding This work was supported by Ministry of Science, Information and Communication Technology, and Future Planning, South Korea (grant number 2013R1A2A2A01068457).
Competing interests None declared.
Ethics approval Institutional Review Board and Ethics Committee of Asan Medical Center.
Provenance and peer review Not commissioned; externally peer reviewed.
Presented at Abstract of this study will be presented at the American Academy of Ophthalmology Annual Meeting, 2017.