Evaluation of anatomical and functional outcome of epiretinal membrane surgery in patients with idiopathic epiretinal membrane

• Main Author: Thamotaran, Tinesh
• Format: Thesis
• Language: English
• Published: 2023
• Subjects: R Medicine; RA Public aspects of medicine
• Online Access: http://eprints.usm.my/62861/

Objective: To evaluate anatomical and functional outcomes of an idiopathic epi-retinal membrane (ERM) between observation group and intervention group at 6-month post-operative. Design: Prospective Cohort study. Participants: Patients who met the clinical diagnosis of idiopathic ERM in the age frame of 18-80 years; patients with reduced visual acuity (VA), with best corrected VA of 0.2 LogMar or worse, with symptoms of significant metamorphopsia, who visited our center from June 2021 to June 2022. Methods: All idiopathic ERM patients who fulfilled the inclusion criteria were selected. The data recorded included the year of ERM diagnosis, duration of symptoms, age at diagnosis, gender, ethnicity, and presence of other ocular pathologies. VA, lens status, ERM configuration, and central subfield mean thickness (CST), ellipsoid zone integrity (EZ), and disorganized retinal inner layer (DRIL) in spectral domain-optical coherence tomography (SD-OCT) were recorded for all patients at diagnosis and 6 months after diagnosis in observation group and at diagnosis and 6 months post-surgery for intervention group. Patients received information on the symptoms associated with ERM, treatment options, and disease progression, then made informed consent of the treatment plan. Main Outcome Measures: VA, CST, EZ and DRIL at diagnosis and 6 months Result: Sixty subjects (30 observation and 30 interventional arms) were recruited for this study. The mean age in the observation and interventional groups was 64.10 + 7.4 years and 62.70 + 8.44 years, respectively. The mean at diagnosis CST was 357.13 + 59.57 μm and 410.03 + 89.06 μm in the observation group and intervention group respectively. The mean difference and 95% confidence interval in post-op CST were - 69.67 (-99.17, -40.17) with significant differences among groups in post-op CST (p<0.001). There was a significant association of EZ integrity between groups (p<0.001), 95% CI of mean difference: (-0.13, -0.01). Meanwhile, there is no significant association of DRIL between both groups (p=0.23), with 95% CI of mean difference (-0.13, -0.01). Furthermore, the mean VA after 6 months and VA Change between observation and intervention groups are significantly different (p<0.001), with 95% CI of mean difference (-0.85, -0.28) and (-0.68, -0.27) respectively. Finally, there is a significant association between the duration of ERM, preoperative VA, intact EZ and CST with post-operation VA outcome at 6 months post-intervention (p<0.05). Conclusion ERM surgery has shown positive outcomes on anatomical and functional aspects. SD-OCT biomarkers, such as CST and EZ have significant association with post-operative visual outcome. It is evident that a longer duration of ERM does have a minimal impact on the outcome.