Analysis of retinal microstructure and electrophysiology in eyes following pars plana vitrectomy and membrane peeling for vitreomacular interface disorders
Abstract Purpose To investigate the relationship between retinal structural biomarkers using spectral-domain optical coherence tomography (SD-OCT) and macular function before and after surgery. Methods Forty-four eyes of 44 patients were included. Ophthalmological examinations included visual acuity...
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2025-04-01
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| Online Access: | https://doi.org/10.1186/s12886-025-04042-7 |
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| author | I-Hsien Chen Meng-Syuan Li Chia-Li Tseng Hung-Pin Tu Shwu-Jiuan Sheu |
| author_facet | I-Hsien Chen Meng-Syuan Li Chia-Li Tseng Hung-Pin Tu Shwu-Jiuan Sheu |
| author_sort | I-Hsien Chen |
| collection | DOAJ |
| description | Abstract Purpose To investigate the relationship between retinal structural biomarkers using spectral-domain optical coherence tomography (SD-OCT) and macular function before and after surgery. Methods Forty-four eyes of 44 patients were included. Ophthalmological examinations included visual acuity (VA), intraocular pressure, OCT angiography (OCTA), and multi-focal electroretinography (mf-ERG) at baseline (pre-surgery) and post-operative follow-up. The ILM texture during peeling was graded by the surgeon as follows: Grade 1, fragile; Grade 2, easy to peel in a sheet; and Grade 3, sticky. The cross-sectional area of the ganglion cell layer and central retinal thickness in the fovea were evaluated using ImageJ software of SD-OCT. The presence of a dissociated optic nerve fiber layer (DONFL) was evaluated using en face OCTA images. mf-ERG results are shown as the ratio between the average amplitudes from rings 1 and 2 (central) and rings 4 and 5 (peripheral): the P1 ratio. Results Based on the SD-OCT morphological characteristics of the foveal area, 14 cases were classified into ERM group 1 (mainly outer retinal thickening or more tenting of the outer retina), 11 into ERM group 2 (prominent inner retinal thickening), 9 into ERM group 3 (ERM with macular hole), and 10 into ERM group 4 (full thickness macular hole without ERM and vitreomacular traction without ERM). Morphological characteristics were correlated with ILM texture (p = 0.0031) and DONFL (p < 0.0001). Group 2 and group 3 ERM had a stickier ILM when peeling and showed DONFL in 100% of the cases. Group 1 ERM had a more fragile ILM when peeling and did not result in DONFL. ILM texture was also correlated with DONFL (p < 0.0001), in which sticky ILM resulted in DONFL after the operation. Eyes with DONFL showed a greater decrease in ganglion cell complex/central retinal thickness in the foveal area, slow P1 ratio recovery, and slower VA improvement. Conclusions ERM with prominent inner retinal structural changes are likely to have a stickier ILM when peeled, leading to a subsequently DONFL. The appearance of DONFL results in an initial decrease in macular function recovery and slower post-operative visual improvement. Surgeons should be more delicate when peeling sticky ILM, especially in eyes with ERM with prominent inner retinal thickening or macular holes. |
| format | Article |
| id | doaj-art-9c3ba792baa84d9c8bba6e57970b3cd6 |
| institution | DOAJ |
| issn | 1471-2415 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | BMC Ophthalmology |
| spelling | doaj-art-9c3ba792baa84d9c8bba6e57970b3cd62025-08-20T03:14:07ZengBMCBMC Ophthalmology1471-24152025-04-0125111010.1186/s12886-025-04042-7Analysis of retinal microstructure and electrophysiology in eyes following pars plana vitrectomy and membrane peeling for vitreomacular interface disordersI-Hsien Chen0Meng-Syuan Li1Chia-Li Tseng2Hung-Pin Tu3Shwu-Jiuan Sheu4Department of Ophthalmology, Kaohsiung Medical University HospitalDepartment of Ophthalmology, Pingtung Veterans General HospitalDepartment of Ophthalmology, Kaohsiung Medical University HospitalDepartment of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical UniversityDepartment of Ophthalmology, Kaohsiung Medical University HospitalAbstract Purpose To investigate the relationship between retinal structural biomarkers using spectral-domain optical coherence tomography (SD-OCT) and macular function before and after surgery. Methods Forty-four eyes of 44 patients were included. Ophthalmological examinations included visual acuity (VA), intraocular pressure, OCT angiography (OCTA), and multi-focal electroretinography (mf-ERG) at baseline (pre-surgery) and post-operative follow-up. The ILM texture during peeling was graded by the surgeon as follows: Grade 1, fragile; Grade 2, easy to peel in a sheet; and Grade 3, sticky. The cross-sectional area of the ganglion cell layer and central retinal thickness in the fovea were evaluated using ImageJ software of SD-OCT. The presence of a dissociated optic nerve fiber layer (DONFL) was evaluated using en face OCTA images. mf-ERG results are shown as the ratio between the average amplitudes from rings 1 and 2 (central) and rings 4 and 5 (peripheral): the P1 ratio. Results Based on the SD-OCT morphological characteristics of the foveal area, 14 cases were classified into ERM group 1 (mainly outer retinal thickening or more tenting of the outer retina), 11 into ERM group 2 (prominent inner retinal thickening), 9 into ERM group 3 (ERM with macular hole), and 10 into ERM group 4 (full thickness macular hole without ERM and vitreomacular traction without ERM). Morphological characteristics were correlated with ILM texture (p = 0.0031) and DONFL (p < 0.0001). Group 2 and group 3 ERM had a stickier ILM when peeling and showed DONFL in 100% of the cases. Group 1 ERM had a more fragile ILM when peeling and did not result in DONFL. ILM texture was also correlated with DONFL (p < 0.0001), in which sticky ILM resulted in DONFL after the operation. Eyes with DONFL showed a greater decrease in ganglion cell complex/central retinal thickness in the foveal area, slow P1 ratio recovery, and slower VA improvement. Conclusions ERM with prominent inner retinal structural changes are likely to have a stickier ILM when peeled, leading to a subsequently DONFL. The appearance of DONFL results in an initial decrease in macular function recovery and slower post-operative visual improvement. Surgeons should be more delicate when peeling sticky ILM, especially in eyes with ERM with prominent inner retinal thickening or macular holes.https://doi.org/10.1186/s12886-025-04042-7Vitreomacular interface disordersInternal limiting membrane peelingVitreoretinal surgeryMulti-focal electroretinogramDissociated optic nerve fiber layer (DONFL)Epiretinal membrane |
| spellingShingle | I-Hsien Chen Meng-Syuan Li Chia-Li Tseng Hung-Pin Tu Shwu-Jiuan Sheu Analysis of retinal microstructure and electrophysiology in eyes following pars plana vitrectomy and membrane peeling for vitreomacular interface disorders BMC Ophthalmology Vitreomacular interface disorders Internal limiting membrane peeling Vitreoretinal surgery Multi-focal electroretinogram Dissociated optic nerve fiber layer (DONFL) Epiretinal membrane |
| title | Analysis of retinal microstructure and electrophysiology in eyes following pars plana vitrectomy and membrane peeling for vitreomacular interface disorders |
| title_full | Analysis of retinal microstructure and electrophysiology in eyes following pars plana vitrectomy and membrane peeling for vitreomacular interface disorders |
| title_fullStr | Analysis of retinal microstructure and electrophysiology in eyes following pars plana vitrectomy and membrane peeling for vitreomacular interface disorders |
| title_full_unstemmed | Analysis of retinal microstructure and electrophysiology in eyes following pars plana vitrectomy and membrane peeling for vitreomacular interface disorders |
| title_short | Analysis of retinal microstructure and electrophysiology in eyes following pars plana vitrectomy and membrane peeling for vitreomacular interface disorders |
| title_sort | analysis of retinal microstructure and electrophysiology in eyes following pars plana vitrectomy and membrane peeling for vitreomacular interface disorders |
| topic | Vitreomacular interface disorders Internal limiting membrane peeling Vitreoretinal surgery Multi-focal electroretinogram Dissociated optic nerve fiber layer (DONFL) Epiretinal membrane |
| url | https://doi.org/10.1186/s12886-025-04042-7 |
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