Article Text
Abstract
Aims To evaluate the visual function and foveal architecture in patients with stage 3 idiopathic epiretinal membrane (iERM).
Methods A cross-sectional observational study included 56 eyes of 52 patients with stage 3 iERM. The patients were classified into type A ectopic inner foveal layers (EIFL) and type B EIFL based on the presence of a continuous hyporeflective band. Visual function and foveal microarchitecture were assessed in enrolled eyes. Best-corrected visual acuity (BCVA), metamorphopsia scores, retinal sensitivity and optical coherence tomography (OCT)/OCT angiography features were compared between two subtypes.
Result The BCVA in type A EIFL and type B EIFL was 0.22 logarithm of minimal angle of resolution (logMAR) (0.15 logMAR, 0.40 logMAR) and 0.53±0.23 logMAR, respectively (p=0.002). Type B EIFL had higher average metamorphopsia scores, especially horizontal metamorphopsia scores, than type A (p=0.013, p=0.007, respectively). Type B EIFL had worse central 2° foveal sensitivity than type A (p=0.034). Type B EIFL had thicker central foveal thickness and EIFL thickness (514.08±73.80 µm vs 444.41±56.57 µm, p=0.001; 159.75±78.30 µm vs 48.44±18.37 µm, p<0.0001; respectively). The foveal avascular zone area of type B EIFL was smaller than that of type A (0.042±0.022 mm2 vs 0.077±0.039 mm2, p<0.0001). The vessel density and flow area of the superficial vascular complex in type B EIFL were larger than those in type A (both p=0.001).
Conclusions Type B EIFL demonstrated significantly worse visual function than type A EIFL, along with marked differences in foveal microstructure and microvasculature. Our study complements the current staging of iERM and helps determine the optimal timing of iERM surgery.
- Retina
- Macula
Data availability statement
Data are available upon reasonable request.
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Footnotes
YH and QW contributed equally.
Contributors Conception and design: LS, XD and LL. Provision of study materials or patients: YH, QW, XL, XZ, XH, WM and SY. Data collection: YH, QW and XL. Analysis and interpretation: YH, QW and XZ. Draft preparation: YH and QW. Revision and editing: YH, QW and XD. XD is the guarantor.
Funding This work was supported by the Construction Project of High-Level Hospitals in Guangdong Province (303020107, 303010303058) and the National Natural Science Foundation of China (82271092).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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